Policy: Kidney/Pancreas Pre-Transplant: Lab Draw Protocol
Statement: : Activation date: 2/27/06
2. Affected Department: Kidney/Pancreas Transplant Program
3. Vision Strategy: Patient Care
4. Policy Statement: The Emory Transplant Center will comply with all applicable federal, state and local
laws, regulations and policies regarding the management patient’s laboratory draws and results.
5. Basis: This policy is necessary for the protection of patients, physicians and staff
6. Administrative Responsibility: Section heads, physicians, practitioners, and staff are responsible for
compliance with this policy.
Scope/Procedure:
7. Protocol:
a. All patients will have laboratory testing done with each visit to the
Outpatient Transplant Center.
*NOTE: 2nd Group & Type (ABORH) will only be performed
at Day 2 of the patient’s transplant evaluation.
b. Different appointment types will require specific laboratory
testing as noted below.
c. Physician may add or remove additional testing as appropriate
for individual patient.
Day One of the Evaluation
Standard Orders
ABO RH Type (need Blood Bank Request)
CBC (WBC, RBC, HGB, HCT, PLT) does not
include differential
Differential, Automated
CMV Total (IgG & IgM)
Comprehensive Metabolic
Hepatitis A Antibody (IgG & IgM)
Hepatitis B (diagnostic profile)
Hepatitis C Antibody
HIV Antibody
Lipid (total cholesterol, HDL, LDL,
triglycerides)
Phosphorous
Protime (PT/INR)
PTT (partial thromboplastin)
RPR (rapid plasma regain)
Toxicology Drug Screen, Blood
Uric Acid
Varicella Zoster Virus Antibody
Urine Tests
Toxicology Drug Screen, Urine (for patients
who are not currently on dialysis)
Urinalysis, Routine
Urine Culture & Sensitivity
Miscellaneous
Amylase
HCG Blood (qualitative) (women <50)
CEA (history of colon cancer)
C-Peptide (type I diabetics)
Hepatitis B DNA by PCR
Hemoglobin A1C (all diabetics)
PTH
Protein Electrophoresis (SPEP)
PSA Screen (Medicare only on all men 40
years and older)
Sickle Cell Screen (African American
recipients)
T4 (free)
TSH (thyroid stimulating hormone)
Fabry’s (is to be ordered on all recipient
evaluation and re-evaluation patients
EXCEPT the following: PCKD, established
etiology of renal failure (biopsy confirming
no-Fabry’s cause i.e., lupus nephritis, fsgs,
etc.), congenital or urological etiologies, type
I diabetics (K/P) or other double organ
transplant candidates (heart/kidney,
liver/kidney)
Mis
cell
ane
ous
Urin
e
24
hour
urin
e
colle
ctio
n for
total
prot
ein,
total
crea
tinin
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and
crea
tinin
e
clea
ranc
e
HLA Orders
HLA Antibody Screen
Lupus Orders – On all patients with a
history of Lupus
Anti-DNA Histone Antibody
Anti-Nuclear Antibody
C3 Complement
C4 Complement
Lupus Anticoagulant Profile
Phospholipids
Hypercoagulation Orders
Anti-cardiolipin Antibody
Anti-thrombin 3
Factor 5 Leiden
Protein C
Protein S
HIV Orders – On all patients with a history of
HIV
CD3/CD4/CD8 Quantitative
EBV Panel
G6PD
HIV Quant./RT-PCR/Ultra sensitive
Lactic Acid Blood
Toxoplasma IgG
Anemia Orders
Vitamin B12 (protect from light)
Ferritin (serum)
Folate
Iron & TIBC
Reticulocyte Count
Day 2 of the Evaluation
Group and Type (ABORH)ABC (Class I)
Molecular Typing
DR/DQ (Class II) Molecular Typing
Autologous Crossmatch
Class I Specificity Testing
Class II Specificity Testing
Re-Evaluation Lab
Standard Orders
CBC (WBC, RBC, HGB, HCT, PLT) does not
include differential
Differential, Automated
Comprehensive Metabolic
Hepatitis A Antibody (IgG & IgM)
Hepatitis B (diagnostic profile)
Hepatitis C Antibody
HIV Antibody
Lipid (total cholesterol, HDL, LDL,
triglycerides)
Phosphorous
Protime (PT/INR)
PTT (partial thromboplastin)
RPR (rapid plasma regain)
Toxicology Drug Screen, Blood
Uric Acid
Varicella Zoster Virus Antibody
Urine Tests
Toxicology Drug Screen, Urine (for patients
who are not currently on dialysis)
Urinalysis, Routine
Urine Culture & Sensitivity
Miscellaneous
HCG Blood (qualitative) (women <50)
Hemoglobin A1C (all diabetics)
PSA Screen (Medicare only on all men 40
years and older)
HLA Orders (As determined by HLA
department)
Class I Specificity Testing
Class II Specificity Testing
HLA Antibody Screen
Approved by: Kidney/Pancreas Transplant Leadership Group
_____________________________________
Tom Pearson, M.D.
Chair, Kidney/Pancreas Transplant Leadership Group
Director, Kidney/Pancreas Transplant Program
Related Policies/Procedures: Pre-transplant Re-evaluation Procedure