immunohematology reference lab


The John J. Moulds Immunohematology Reference Laboratory (IRL) is one of only 61 AABB accredited IRLs in the country and a member of the American Rare Donor Program. Established as a reference lab in the 1970s, currently it is one of the leading suppliers of rare blood in the nation with an internationally known rare red cell collection and ability to match and supply compatible blood for patients with rare antibodies. The IRL is staffed with licensed medical technologists and Specialists in Blood Banking.

Reference Lab Locations

Shreveport Immunohematology Reference Laboratory
8910 Linwood Ave, Shreveport, LA 71106

Lake Charles Reference Laboratory
214 Dr. Michael DeBakey Drive, Lake Charles, LA 70601

Shreveport Immunohematology Reference Laboratory Hours

7am-5pm (Monday-Friday)
Routine hours, full staff coverage. Routine and complex compatibility and antibody identification services provided. In house staff available for consultation service regarding antibody interpretations, product selection, and availability of compatible blood products.

5pm-7am (Monday-Friday)
Non-Routine hours, reduced staff coverage. Priority requests. Routine workups completed if workload permits. Priority based on patient need and available resources.

Saturday & Sunday
Non-Routine hours, reduced staff coverage. Routine compatibility and antibody identification services provided. Priority will be given to samples based on patient urgency and available resources.

Lake Charles Reference Laboratory Hours

8am-5pm (Monday-Friday)
Routine hours, full staff coverage. Routine and complex compatibility and antibody identification services provided. In house staff available for consultation service regarding antibody interpretations and availability of compatible blood products.

8am-5pm (Saturday & Sunday)
Non-Routine hours, reduced staff coverage. Priority requests. Routine workups completed if workload permits. Priority based on patient need and available resources.

After hours services in Lake Charles are provided on a limited basis and all requests for testing must be coordinated with either a Lake Charles or Shreveport Laboratory staff member. Based on the availability of a Lake Charles technologist and complexity of the request, testing may be performed in either Lake Charles or Shreveport. While every effort will be made to provide timely compatibility testing and antibody identification, requesting facilities may experience increased wait times after hours and on weekends.

Requesting Services

LifeShare’s accredited Immunohematology Reference Laboratory is available to assist referring hospitals in resolving serological problems and locating compatible blood products when requested. Due to the complexity of this work, resolving problems or finding compatible blood may not be accomplished in the time frame requested by the submitting facility. When this occurs, the requesting facility will be notified of any delays. When delays are experienced, the hospital staff must make the decision regarding transfusion therapy in urgent or emergent situations. LifeShare’s Medical Director is available for consultation in these circumstances.

Sample Submission Categories

Submitted samples will be prioritized based on patient status in consultation with the facility. Initial evaluations may take 4 to 8 hours with final reports normally completed within 72 hours.

  • Routine

    Test results or crossmatch compatible products needed within twelve hours. Routine requests will be triaged and completed based on the order received and specific needs of the patient.

  • Priority

    Test results or crossmatch compatible products needed within six hours. Priority requests will be triaged and completed before routine work providing a complex antibody identification workup is not required. Priority requests will be triaged based on specific need of the patient.

  • Routine and Priority are internal classifications used by laboratory staff to triage requests. Facilities submitting a request should provide a specific date/time when results or products are need.

Samples requiring advanced testing due to complex antibody identifications or a need to locate and crossmatch rare units may experience extended delays. When these occur, the requesting facility will be notified of the delay and estimated completion date/time. Due to limited availability of rare testing reagents, investigations of antibodies to some high frequency antigens may require multiple days to resolve and locate compatible blood products.

Request Forms

  • LifeShare Form L-35, Consultation/Compatibility Request Form

    The L-35 is used to request reference and compatibility services from the reference lab. This may involve the identification of antibodies, a request for antigen negative units, or routine crossmatching of blood products for transfusions.

Submitting the Request Form

Call the Laboratory technologist to notify of intent to submit sample. Specify any known problems with transfusion or reactivity currently encountered.

Complete Side 1 of Consultation Request (Form L-35).

  • When possible, the patient Social Security Number (SSN) should be provided. This provides a unique identifier that allows the laboratory to maintain continuity of care for the patient if treated at multiple facilities. If unable to supply SSN, a Patient ID number should be provided that will forever identify the patient at the requesting facility. Additionally, a unique ID number must be provided. This number will be used on all tags and paperwork when crossmatching is performed. It is acceptable to use the SSN or Patient ID for the unique ID number provided the number is written on the ID number line.
  • In order to resolve the problem as quickly as possible, please provide all information requested. Incomplete or incorrect submissions may cause delays.
  • “Date/Time Needed” must be indicated to help the technologists prioritize and schedule all requests submitted to the laboratory. This should reflect the actual time the blood is needed for transfusion.
  • Fax a copy of the completed request form to the laboratory.
  • Send the completed request form to the laboratory with the patient’s sample.

Laboratory Submitting Samples

Sample Requirements

  • For antibody identification

    Collect two 7-mL EDTA (purple or pink top) samples and a 10-mL clotted (plain red top) sample from the patient. Additional blood may be requested for complex problems. Do not send samples in gel separator tubes. Do not separate samples.

  • For crossmatch only

    Collect one 7-mL EDTA (purple or pink top) sample and a 10-mL clotted (plain red top) sample from the patient. Additional blood may be requested if unexpected antibodies are observed. Do not send samples in gel separator tubes. Do not separate samples.

Sample Labeling

Label each tube with

  • Complete patient name (Last, First, Middle Initial) as it appears on hospital records. (Note: On computer generated labels, ensure entire patient name prints on label.) Name on tube must match name on written request form.
  • ID number. (Note: ID number must match the ID number on the written request form.)
  • Date and time sample drawn
  • Phlebotomist’s initials

Sample Shipping

  • Prepare samples and request form for shipment to Laboratory using standard protocol for shipment of biological specimens.
  • Ship samples and request form to the appropriate Laboratory. Shipping may be arranged by contacting the local LifeShare Blood Center to coordinate transport on a scheduled courier run. Alternately, samples and request form may be shipped via mail or facility arranged courier. Samples shipped directly from a facility must be on wet ice in an insulated container. Insulated containers are available from the local LifeShare Blood Center.
  • Notify Laboratory of estimated arrival time for specimen.

Laboratory - Results/Findings

A written preliminary report communicating the results of the investigation will accompany blood products to the requesting facility. For workups where no blood products are requested, the preliminary report will be faxed to the facility upon completion of the serological investigation. Following supervisory review, a final report will be sent to the requesting facility by mail.

When requested, the blood center technologist will verbally communicate results of investigations as soon as they are available to the blood bank of the facility indicated on the Consultation Request.

Records of all patient testing will be filed at LifeShare Blood Centers.

Laboratory - Special Services

Washed Blood

There are very few clinical indications for washing red cell units. Multiple progressive allergic reactions and patient antibodies against immunoglobulin A (IgA) are the two most common. Washing is performed in an open system and requires 2 to 3 hours for completion. The washed product has a 24 hour expiration. Due to the clinical considerations for washing blood products, Medical Director approval is required for all requests. Please contact the reference lab for additional information.

Laboratory -Transfusion Reactions

Signs and Symptoms

Signs and symptoms may present during transfusion or in the hours/days post transfusion that may indicate a possible transfusion reaction. The following is a list of possible indicators:

  • Fever greater than 1°C (2°F) above pre-transfusion baseline
  • Chills
  • Backache
  • Shortness of breath
  • Respiratory distress
  • Rash, hives, or itching
  • Nausea or vomiting
  • Chest pain
  • Abnormal pain of indeterminate origin
  • Hemoglobinuria (pink, red or dark colored urine)

Immediate Actions

When a transfusion reaction is suspected (These actions are tailored to LifeShare Compatibility customers. Always follow local procedures for evaluation of suspected transfusion reactions):

  • Stop the transfusion
  • Notify the attending physician
  • Collect and label post-transfusion samples from patient: [One 7-mL EDTA (purple or pink top) sample and a 10-mL clotted (plain red top) sample]
  • Complete LifeShare Form L-49, Report of Transfusion Complication
  • Notify LifeShare of suspected transfusion reaction
  • Send the following to LifeShare:
    • Completed Form L-49
    • EDTA and Red top samples
    • Blood component bag with all attached tubing and fluids

Laboratory Investigation

Laboratory investigation will include:

  • Clerical check of component bag, label, paperwork, and patient sample
  • Repeat of ABO testing on the post-transfusion sample
  • Visual check of pre- and post-transfusion sample to evaluate for evidence of hemolysis
  • Direct antiglobulin test (DAT) on post-transfusion sample
  • Additional testing based on initial findings

In the event Transfusion Related Acute Lung Injury (TRALI) or Transfusion Associated Circulatory Overload (TACO) is suspected, additional information may be requested.

TRALI

Transfusion-Related Acute Lung Injury (TRALI) is a respiratory complication often associated with infusion of antibodies to leukocyte antigens during transfusion of blood products. Clinical signs and symptoms typically include fever, chills, dyspnea, cyanosis, hypotension, and new onset of bilateral pulmonary edema. If TRALI is suspected following transfusion of blood products:

  • Notify one of LifeShare Blood Centers' Laboratories at either 318.673.1466 (Shreveport) or 337.439.5851 (Lake Charles).
  • Complete Section 1 of LifeShare Form L-41, Evaluation of Suspected TRALI.
  • Additionally, list the unit numbers (BUN) and component type in Section 2 of all blood products transfused within past 24 hours.
  • Once complete, Fax the form to either Shreveport 318.227.8317 or Lake Charles 337.494.3853.
  • TRALI evaluation may take up to 30 days to complete.

Laboratory - CLIA and AABB Certificates

          LifeShare Blood Center, established in Shreveport, La. in 1942, regularly supplies blood components and related services to more than 100 medical facilities and hospitals throughout Louisiana, East Texas and South Arkansas. LifeShare is a member of America’s Blood Centers and the American Rare Donor Program, is licensed by the U.S. Food & Drug Administration, and accredited by AABB. LifeShare Blood Center is a 501(c)(3) nonprofit community blood bank governed by a volunteer Board of Trustees.