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Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each

CPT4 code

Name of the Procedure:

Pretreatment of Red Blood Cells (RBCs) for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes.

Summary

Pretreating red blood cells with enzymes is a laboratory process used to enhance the detection and identification of antibodies against RBCs. This involves treating the RBCs with specific enzymes, which can improve the accuracy and sensitivity of tests used for blood transfusions or diagnosing blood disorders.

Purpose

This procedure is designed to identify the presence of antibodies that may target red blood cells. By preprocessing RBCs with enzymes, it makes it easier to detect these antibodies, ensuring safer blood transfusions and better management of blood-related conditions. The goal is to prevent transfusion reactions and accurately diagnose immune-related blood disorders.

Indications

  • Patients requiring blood transfusions.
  • Individuals with suspected autoimmune hemolytic anemia.
  • Patients with a history of transfusion reactions.
  • Pregnant women at risk for hemolytic disease of the newborn.
  • Individuals undergoing pre-surgical blood compatibility testing.

Preparation

  • No specific patient preparation required, as this is a laboratory-based procedure.
  • Blood samples must be collected and labeled correctly.
  • Standard diagnostic blood tests may be required beforehand.

Procedure Description

  1. A blood sample is collected from the patient.
  2. Red blood cells are isolated from the blood sample.
  3. Enzymes, such as papain or ficin, are added to the red blood cells.
  4. The mixture is incubated for a specified period, allowing the enzymes to treat the RBCs.
  5. Post-incubation, the RBCs are washed to remove any residual enzymes.
  6. The pretreated RBCs are then used in antibody screening and identification tests.

Duration

The enzymatic incubation and subsequent procedures typically take 1-2 hours.

Setting

This procedure is performed in a clinical laboratory.

Personnel

  • Medical Laboratory Technicians
  • Hematologists
  • Microbiologists

Risks and Complications

  • Minimal risk to the patient, as the procedure is done on blood samples outside the body.
  • Potential for incorrect interpretation if enzyme-treated cells are not handled properly.

Benefits

  • Increased accuracy in detecting and identifying RBC antibodies.
  • Reduced risk of transfusion reactions.
  • Enhanced safety for blood transfusion recipients.

Recovery

  • No recovery needed as the procedure is conducted on blood samples.
  • Results are typically available within a few hours to a day.

Alternatives

  • Standard antibody detection methods without enzymatic treatment.
  • Molecular methods for antibody identification.
  • Each alternative has varying degrees of sensitivity and specificity.

Patient Experience

  • The patient will experience a standard blood draw.
  • No additional discomfort or pain related to the enzymatic pretreatment procedure itself.
  • Routine care and pain management for blood draw, if needed.

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