The Blood Transfusion laboratory provides haemostatic support for patients, supplying compatible blood products in cases such as leukaemia, haemophilia and haemoglobinopathies, and for operative or trauma-related blood loss. The laboratory is regulated by the MHRA.

Clinical Advice

The Transfusion laboratory offers a full service for cross-match and issue of blood products with out-of hours cover. Red cells, plasma products, factor concentrates and albumin are kept on site whereas platelets are requested and delivered as necessary from NHS Blood and Transplant (NHSBT). Requests for blood products are welcomed during normal working hours (08:00 - 17:00 Monday to Friday, not Bank Holidays) when the laboratory is fully staffed. Out-of-hours requests should be reserved for emergency patients only as routine overnight transfusion is discouraged on patient safety grounds.

Clinical advice is available from the department on a 24/7 basis. This will be provided by a Consultant Haematologist on a rota basis. The laboratory also has a team of Biomedical Scientists who can provide information on requesting, specimen collection, interferences, validity of results, biological variation and additional testing. Please see the Service Hours [1]section for contact details.

The Hospital Transfusion Team (HTT) comprises the Transfusion Practitioner team, Blood Bank Manager and a Consultant Haematologist. The laboratory and HTT actively participate in clinical and laboratory based audits as well as educational programmes. They are happy to discuss and advise on any transfusion issues. Please see the Key Contacts [2] section for contact details.

Transfusion Analysers and Electronic Issue
The laboratory is equipped with two ORTHO Vision immunohaematology analysers which identify patient blood groups and the presence of atypical red cell antibodies, perform antibody panels and serological crossmatching. The direct transmission of results from the analysers to the hospital laboratory information systems without human data entry enables the vast majority of patients with no atypical antibodies to be electronically issued blood without need for a serological crossmatch, when there is a valid Group and Screen sample and a historic blood group on record. 

Manual Techniques
All testing performed via laboratory automation can also be performed via manual methods if necessary. However, manual testing is often only utilised when the analyser is unavailable or out of service. Currently,  D variant testing for neonates is the only routine procedure regularly performed using manual methods.

Liaising with Blood Product Suppliers
The laboratory liaises closely with NHSBT and several other blood product manufacturers to ensure a timely provision of haemostatic support to hospitals in the Peterborough and Stamford area. Stocks of blood, plasma, cryoprecipitate, prophylactic anti-D and human-derived/recombinant clotting factors are kept on-site in controlled-temperature environments in sufficient quantities for routine requirements. If a patient has a requirement for blood products of a specific antigenicity not held on-site, requires platelets (which have too short a shelf-life to store on-site), or requires more units of a blood product than can be comfortably supplied from on-site stocks, these are ordered from NHSBT with an urgency matching the requirements of the patient (ranging from next-day delivery for routine pre-operative requests, to blue-light emergency delivery).
Where in-house testing for blood group and antibody status is inconclusive, or if new antibodies have been identified and require confirmation by a third party, additional samples may be requested by Blood Transfusion laboratory staff for send-away to NHSBT who have a wider range of testing materials and more specialised equipment. In extreme cases where a patient's antibody status would prevent us from safely issuing blood, samples can be sent to NHSBT for crossmatching by their own reference laboratory.

Antenatal Care
In addition to the issue of blood products for haemostasis, the Blood Transfusion laboratory is also responsible for the distribution of prophylactic anti-D for RhD negative pregnant women, preventing the commonest form of haemolytic disease of the foetus and newborn (HDFN) by removing foetal blood from the maternal circulation before an immune response can be raised against it. Foetomaternal haemorrhage tests are performed on blood samples of RhD negative mothers >20 weeks gestation who have undergone a potentially sensitising event (labour, trauma, etc.) to ensure adequate prophylactic anti-D is administered to remove all foetal blood that has entered the mother's circulation. Flow cytometry is used to accurately estimate foetomaternal bleeds on all samples processed on routine working days, and on any processed at other times that have a bleed >2ml estimated by the manual Kleihauer method.