The Immunohematology Reference Laboratory (IRL)
The Immunohematology Reference Laboratory (IRL) is certified by AABB to offer services that provide hospitals, medical facilities and patients with compatible blood for transfusion, including:

• Compatibility testing (crossmatching) and detection of unexpected antibodies
• Simple to very complex serological work-ups using a variety of techniques
• Obtaining rare units of blood for patients with complex antibody problems; including nation-wide searches through the American Rare Donor Program
• Management of transfusion-related complications
• 24/7 access to Carter BloodCare staff

Platelet services are provided to help ensure that transfused platelets will survive in the patient. These nationwide services include HLA matching of donors to recipients through an extensive HLA database. We also provide platelet crossmatching, platelet antibody screening and neonatal alloimmune thrombocytopenia studies.

The Flow Cytometry Analyzer is currently being used in our Lab for several functions:

• Product quality assurance, including both red cells and platelets
• Monitoring the cytometric analysis of stem cell collections
• Analyzing for the amount of fetal hemoglobin in problem pregnancies

The Stem Cell Transplant Laboratory at Carter BloodCare provides comprehensive support for bone marrow and stem cell transplant patients. The laboratory strictly adheres to quality assurance processes, has computerized inventory management and is registered with the FDA. In addition, the laboratory is one of three stem cell transplant labs in North Central Texas to be fully accredited by the Foundation for the Accreditation of Cellular Therapy (FACT). The manager has more than 8 years of stem cell processing experience and is board certified by the American Society for Clinical Pathology (ASCP) with a specialty in blood banking (SBB). Each medical technologist is board certified by ASCP, with a Bachelor of Science degree in Medical Technology. All have received specialized training and are uniquely qualified to perform peripheral blood stem cell and bone marrow processing and cryopreservation. In addition, they have the ability to process cord blood allografts supplied by NMDP, The New York Blood Center, The St. Louis Cord Blood Bank and as far away as StemCyte in Taiwan.

Services offered include:

• Processing of peripheral blood stem cells (PBSCs) and bone marrow
• Cryopreservation of HPCs using controlled rate freezing
• LN2 vapor phase storage of all HPCs with 24-hour monitoring of inventory
• Daily communication with bone marrow transplant coordinators and physicians concerning cell counts
• Written consultation reports of cumulative data for each patient
• Computerized data collection and tracking of components from the time of receipt to final disposition
• Delivery and bedside thawing of HPCs at the time of transplant
• Processing and cryopreservation of allografts in escalating CD3/kg cell doses for donor leukocyte infusions (DLI)
• Umbilical cord blood thawing and washing of allografts (COBLT certified)
• Assisting with surgical harvest of autologous and allogeneic bone marrow in the operating room
• Assistance in preparing other transplant laboratories for AABB and FACT accreditation

The laboratory has experience processing ABO compatible and ABO incompatible PBSCs and bone marrow collected from autologous and allogeneic, pediatric and adult stem cell donors. This includes allografts collected by the National Marrow Donor Program (NMDP). Routine processing of each component includes the evaluation of cell counts, viability, flow cytometric analysis for CD34 and CD3, and pre- and post-processing bacterial and fungal blood cultures. Plasma and red cell depletion procedures are performed whenever indicated. Cryopreservation of stem cells is performed using a controlled rate freezing system and a cryoprotectant solution containing 10% DMSO, an electrolyte solution (Plasma-Lyte Añ pH 7.4) and a source of protein (25% human albumin). As a means to prevent cross contamination, all cryopreserved components are placed inside an overwrap bag, then stored in the vapor phase of liquid nitrogen in specially designed freezers. When cells are requested for transplantation, they are delivered in specialized transport containers by laboratory staff personnel directly to the bone marrow transplant unit or outpatient clinic and thawed at the recipient’s bedside.

The Stem Cell Transplant Laboratory technologists have also been trained in sterile technique and have the ability to assist the transplant physician in the operating room during adult or pediatric, autologous or allogeneic bone marrow harvest procedures.

CD34 selection or other methodology for T-cell depletion. For more information about our services, please feel free to contact us at 817-412-5743.

Carter BloodCare provides Clinical Apheresis services to treat many diseases such as sickle cell anemia, TTP, Guillain-Barre, Waldenstrom’s Macroglobulinemia, severe leukemic blast crisis and myasthenia gravis. Consultative apheresis services are also provided by our staff and medical directors, free of charge. Both adult and pediatric apheresis procedures are performed in hospitals, in outpatient clinics and certain Carter BloodCare Donor Centers.

Collection services include:

• hematopoietic progenitor cells (stem cells)
• lymphocytes
• granulocytes
• other types of leukocytes for research and bone marrow processing

Therapeutic apheresis services include:

• plasma exchange
• red blood cell exchange
• photopheresis
• leukocyte depletion
• platelet depletion

The Clinical Apheresis department is also the collection site for the National Marrow Donor Program (NMPD) at Cook Children’s Medical Center and Scott & White Hospital in Temple. The department is also the stem cell collection site for Children’s Medical Center of Dallas and UT Southwestern Medical Center.

The Clinical Apheresis team provides services 24/7. The department is directed by an RN and certified Hemapheresis Practitioner (ASCP), managed by an RN and certified Hemapheresis Practitioner (ASCP), and is staffed by a team of nurses, medical technologists, apheresis technicians and a patient support specialist.

Carter BloodCare has three full-time physicians with more than 50 years of combined blood banking related experience. Carter BloodCare provides medical and technical consultations to area physicians who require assistance in dealing with complex and difficult transfusion medicine related cases.

Carter BloodCare is committed to furthering the field of transfusion medicine. Our physicians hold faculty positions with the University of Texas Southwestern Medical Center in Dallas. Since 1994, we have participated in the fellowship training of physicians wishing special expertise in Transfusion Medicine. The one-year fellowship is a joint effort among Carter BloodCare, the University of Texas Southwestern Medical Center and Parkland Health and Hospital Systems. This fellowship in Transfusion Medicine and Blood Banking is accredited by the American College of Medical Graduate Education. Carter BloodCare is also a training facility for undergraduate Medical Technologist programs at local universities and, in conjunction with the University of Texas Southwestern Health Science Center, conducts a graduate program leading to a Specialist in Blood Banking degree.

Carter BloodCare is very active in research activities designed to improve the safety and the adequacy of our blood supply. Current projects involve blood donor motivation, effectiveness of virally inactivated plasma products, and evaluating donor loss resulting from proposed new federal regulations.