DTM Changes

[HLA Laboratory]  [TTV Laboratory]  [Transfusion Services]

HLA Laboratory

[MIS Screen 1]  [MIS Screen 2]  [MIS Screen 3]  [MIS Screen 4]  [MIS Screen 5]  [MIS Screen 6]

The HLA Test Ordering Screens in MIS will now appear as shown to the right.  Regardless of your own particular menu pathway, you should arrive at the top screen to order HLA Tests.  There are six different, HLA series of tests, that can be ordered.

The first three tests, HLA A,B & HLA DR, DQ,  HLA A,B and HLA DR,DQ will comprise the bulk of all ordering. 

If you need both HLA A,B (Formerly Class I) and HLA DR,DQ (Formerly Class II), you would now use Test HLA A,B & HLA DR,DQ.

If you only need only HLA A,B (Class I) and not HLA DR,DQ (Class II), then only order HLA A,B.

Conversely, if you only need HLA DR,DQ (Class II), only order HLA DR,DQ.

Some investigators may need HLA Cw as part of their HLA profile.  Although HLA Cw is a component of the Class I Alleles, the molecular testing now used for HLA identification dictates that HLA Cw  be tested as an individual component. This test will have to be ordered separately with the HLA Cw selection.

Currently the NIH HLA Lab offers HLA A*02 and HLA A*03 locus subtyping.  If an investigator requires either of these subtypes, then selecting HLA subtyping will bring you to the ordering screen for the specific subtyping selections.

HLA serum antibody screening is selected by the last test selection, HLA Serum Screening.

After the appropriate tests have been ordered, the second screen will appear.  This screen is used to determine the specimen tube type and the volume required for the HLA testing.  Additionally if an investigator knows that a particular test is only necessary under specific conditions, the Optional Select criteria is given near the bottom of the screen.  Pressing CONTINUE will advance you to the next screen.
HLA1.GIF
HLA2.GIF

The third screen is used to help the HLA Lab properly categorize the test request.  The ordering Physician information can be very important if questions arise concerning the Sample or the Patient.

The priority of the test: Routine, Urgent or STAT, will help ensure work is completed in the appropriate time frame.  If no selection is made the test is considered routine.

If the Test is ordered as part of a Transplantation Protocol the TRANSPLANTATION information should be completed.  The HLA laboratory must know if a sample belongs to the intended recipient or a potential donor.

If the subject tested is part of a family that is being studied, the HLA Laboratory must know whether the sample belongs to the MIS Index patient or another family member.

If either TRANSPLANTATION DONOR or FAMILY STUDIES FAMILY MEMBER is selected, the fourth screen appears. This screen links the donor to the recipient (patient) or family member to the index patient. It also identifies the relationship of the individual to the index patient.  The information is very important for keeping information on the entire group (i.e.  Recipients and donors or entire families) together for reporting purposes.

If the Sample is from a category other than a Transplantation or Family Study, then OTHER is the proper selection.

 

The final two screens are the same as existing MIS screens.  No changes to the ordering mechanism were made.

 

Contact

Jim Reid (496-8852)  jreid@dtm.cc.nih.gov

 

 
HLA3.GIF
HLA4.GIF
HLA5.GIF
HLA6.GIF

TTVL(Viral testing)

 Ordering Changes

    none

Results

    The result screens and Daily printouts will look a little different for TTV testing. Instead of having "NEG by EIA #…" or "POS by EIA #…" followed by a number, there will be "EIA……." and then the interpretation of the result. If any confirmatory testing was performed, that result will be below the EIA along with any qualifying statements, date of result and tech initials. The tests performed in TTV are considered alphanumeric and SoftLab sends an interpretation of the test result back to the MIS.

EXAMPLE:

Valentino, Rudolph44-55-66-7 MOP7MD: Smith, Joe

HEP. B (HB S AG)

EIA………….REACTIVE

Confirmed Positive by neutralization.

11/23/98. BJ

Reports

    Continue to print from MIS.

Contact

    We feel the new reporting of TTV results will be more informative and easier to read. If there are any questions, please call 496-8842.

Transfusion Services

Ordering Changes

  • Screen 21523 - Blood components have been reorganized. Cellular components RBC and Apheresis platelets are displayed first. You must select the >NEXT at the bottom of the page to access options for WBC components, other cellular components such as PBSC and Bone Marrow, and Plasma Components. Autologous RBCs are now ordered under the RBC option on this screen, as are Directed Donor RBC.
    • Screens 16344, 16812, and 16345 - Pre-OP Blood Orders (MSBOS) screens have been updated to reflect current surgical procedures performed by the Clinical Center. These changes were reviewed and approved by the surgeons and the Transfusion Committee.
  • Screen 13089 - This order option has changed to allow selection of the component type RBC and then selection of all modifications required for the product. Options available are: Irradiated to Prevent GVHD, Leukocyte Reduced (Filtered), and Washed. One or all options may be selected for the RBC order. Deglycerolized RBC are no longer an option for selection but are available by special request to the DTM.
  • Screen 07429 - The Platelets Index screen has been similarly modified to allow selection of the component type Apheresis Platelets and then selection of all modifications required. Options available are: HLA Selected, Leukocyte Reduced (Filtered) and Washed. All platelets are irradiated per DTM policy.
  • Screen 17993 - This screen allows selection of WBC components, other cellular components such as PBSC, bone marrow genetically altered lymphocytes, and plasma components. Fibrin sealant has been added to the menu as a selection option. Liquid plasma has been removed as an option but may be obtained by special request to the DTM.
  • Screen 01740 - The Transfusion Medicine Test screen has been modified significantly. The option to order ABO and Rh, and antibody screen as separate tests has been deleted. The group test Type and Screen includes an ABO group & Rh type and an indirect antiglobulin test (antibody screen). Direct coombs is still available as a separate test selection and may be ordered with a type and screen to provide a screen for immune hemolysis. RBC phenotype is now ordered on this screen, as are cold agglutinin titers. Other changes to this screen are the addition of Isohemagglutinin titers as a test selection and an option to view additional reference tests offered through consultation.

Results

    TBD

Reports

    TBD

Contact

    These changes have been pre-viewed by members of the NIS committee who feel the new format is more logical and self-explanatory. However, if you experience any difficulty in ordering the tests or blood components you require, please contact Sherry Sheldon at 496-8335 or by email at ssheldon@mail.cc.nih.gov.

 
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Last modified on February 19, 1999.  
Comments/Suggestions to kroden@nih.gov