Guideline and Procedure Title and Document No. Guideline and Procedure Renal: Monthly tissue typing collection Sites where Guideline and Procedure applies Target audience: Description This Guideline and Procedure applies to: 1. Adults 2. Children up to 16 years 3. Neonates – less than 29 days HNE health facilities where a renal patient currently on transplant waiting list receives care. Nephrology clinical staff, who provide care to renal patients who are on transplant waiting list. Yes No No Keywords Tissue typing, transplant, waiting list, blood collection, HLA, acute rejection Replaces Existing Guideline and Procedure Yes Registration Number(s) and/or name and of JHH Nephrology SWP N.4.2 Superseded Documents Related Legislation, Australian Standards, NSW Health Policy or Circular, EQuIP Criterion, other HNE Health Documents, Professional Guidelines, Codes of Practice or Ethics: EQuIP Criterion: NSW Health Policy Directive 2007_079 Correct patient, Correct procedure, correct site http://www.health.nsw.gov.au/policies/pd/2007/pdf/PD2007_079.pdf NSW Health Policy PD 2005_406 Consent to Medical Treatment http://www.health.nsw.gov.au/policies/PD/2005/pdf/PD2005_406.pdf NSW Health Policy Directive PD 2007_036 Infection Control Policy http://www.health.nsw.gov.au/policies/pd/2007/pdf/PD2007_036.pdf Hunter new England Local Health Net work Guidelines and Procedures: Renal: Blood Collection via Haemodialysis Access HNELHD GandP 12_05 Prerequisites (if required) Nil Guideline and Procedure Note This document reflects what is currently regarded as safe and appropriate practice. The guideline section does not replace the need for the application of clinical judgment in respect to each individual patient but the procedure/s require mandatory compliance. If staff believe that the procedure/s should not apply in a particular clinical situation they must seek advice from their unit manager/delegate and document the variance in the patients health record. If this document needs to be utilised in a Non-Nephrology Area please liaise with the Nephrology Service to ensure the appropriateness of the information contained within the Guideline and Procedure. Position responsible for the Tier 2 Executive or Network or Stream Clinical Leader (or applicable Guideline and Procedure and committee) with authority to authorise authorised by Contact Person Kelly Adams, Tina Straker Contact Details Date authorised This Guideline and No Procedure contains advice on therapeutics Date of Issue Review due date TRIM Number Version Number Month and Year Guideline and Procedure Title and Document No. RISK STATEMENT Staff may potentially be exposed to body substance and needle injury when carry out this procedure. Therefore strict Infection Control and Occupational Health and Safety rules should be followed when attend this procedure, including wearing recommended Personal Protective equipment and following the procedure steps. Any unplanned event resulting in, or with the potential for, injury, damage or other loss to patients/HCN/visitors as a result of this procedure must be reported through the Incident Information Management System and managed in accordance with the Ministry of Health Policy Directive: Incident Management PD2007_061. OUTCOMES 1 Correct tissue typing is collected, labeled and sent to the Red Cross at the correct time each month 2 Enabling the patient’s details to be updated on the current transplant waiting list ABBREVIATIONS & GLOSSARY Abbreviation/Word Definition Acute rejection An early and rapid antibody-mediated rejection that is not easily controlled with immunosuppression medication HLA Hyperacute rejection HAPS GP Human Leukocyte antigens The immediate and usually irreversible destruction of the transplanted kidney Hunter Area Pathology Service General Practitioner GUIDELINE A tissue type test is a blood test that measures substances called anti- human leukocyte antigens on the surface of body cells and tissues. Checking the antigens permits assessment of donor and potential recipients for degree of histocompatibility, and prevent the risk of hyperacute rejection. This procedure is typically used prior to transplantation of tissues or organs. The monthly tissue typing blood samples need to be sent to Red Cross in Sydney by the 20th day of the month to enable cross-match when a kidney becomes available. PROCEDURE This procedure requires mandatory compliance. Patient Preparation It is mandatory to ensure that the patient has received appropriate information to provide informed consent and, that patient identification, correct procedure and correct site process is completed prior to any procedure. Patients are to inform staff when a sample of blood for tissue typing is due. Staff Preparation It is mandatory for staff to follow relevant: “Five moments of hand hygiene”, infection control, Version Number Month and Year Page 2 Guideline and Procedure Title and Document No. moving safely/safe manual handling, and documentation practices. Equipment Requirements Alcohol based hand rub Personal Protective Equipment including protective eye wear & non-sterile gloves 8 ml Z serum Sep. clot activator tube x1 Vacutainer Sheath x1 Vacutainer Leur Adaptor Procedure Steps 1. Collect blood as per Renal guideline and procedure- Renal: Blood Collection via Haemodialysis Access HNELHD GandP 12_05 2. All samples are to labeled correctly with the patient’s full name, date of birth and date of collection 3. Patient samples in the Greater Newcastle are couriered to the Nephrology department CSU by HAPS and dispatched to Sydney together. Note: For peritoneal dialysis, home patients and patients in the area have no HAPS eg. Moree, and Narrabri, patients are to attend GP service or pathology of their choice for blood collection. REFERENCES Hand Hygiene Australia Danovitch, G.M. (2005) Handbook of Kidney Transplantation, Philadelphia: Lippincott Williams & Wilkins FEEDBACK Any feedback on this document should be sent to the Contact Officer listed on the front page. Version Number Month and Year Page 3