The AABB accredited Immunohematology Reference Laboratory (IRL) at Carter BloodCare provides a broad range of blood bank tests as well as molecular RBC genotyping, transfusion services, flow cytometry testing, and platelet-matching services throughout North, Central, and East Texas, and periodically across the nation.

All R&T laboratories are staffed with certified Medical Technologists (MLTs/MTs) that provides services 24 hours a day, 7 days a week. All R&T laboratories are managed by and/or staffed with multiple experienced specialists in blood banking (SBB) technologists and Medical Directors (MD) that are available for consultation services 24/7. Additionally, other specialty trained staff in molecular, flow cytomertry, HLA, and platelet services are available to support the laboratories and client needs.

The Reference & Transfusion laboratories provide a comprehensive range of services including, but not limited to

  • Provision of antigen negative units (including rare antigens)
  • Compatibility testing of confirmed antigen negative units
  • Provision of historically antigen negative units (C,c,E,K) for cooperative management of the chronically transfused patient (i.e. hemoglobinopathies and thalessemia)
  • Participation in the national American Rare Donor Program (ADRP)
  • Transfusion services including detection of unexpected antibodies and compatibility testing
  • Antibody identification (simple/complex) through use of a variety of techniques such as Gel, Tube (LISS/PeG), enzyme treatment, and Solid Phase (Echo)
  • Modified workup for eligible chronically transfused patients
  • Platelet services – antibody screen, crossmatch, HPA-1a negative and/or HLA matched pets
  • Molecular genotyping for red cell antigens (patient and donor)
  • Investigation and Management of transfusion complications (transfusion reaction workups)
  • Assistance with clinical trial studies
  • Known samples to assist with competency assessments, and/or validations

Please refer to the sections below for more details.

Transfusion Services

The Immunohematology Laboratory offers several options for transfusion services. These options include full service on-site, limited service on-site, and remote services.

Our experienced staff in the North and East Texas laboratories performs remote transfusion services (Crossmatch Accounts). These services include determining patient blood group, detection and identification of unexpected antibodies, and provision of compatible plasma products (platelets, fresh frozen plasma, and cryoprecipitate) and crossmatch compatible red blood cells tagged and ready for immediate transfusion. Emergency release units, massive transfusion protocol, on-site emergency release stock and rotation of emergency release stock services are available based upon need and request.

Full service on-site services includes experienced staff and equipment onsite within the facility fulfilling all transfusion needs for the facility. These services include determining patient blood group, detection of unexpected antibodies, simple antibody identification, and provision of compatible products. Products such as platelets, thawed plasma, cryoprecipitate, red blood cells (antigen negative) would be provided and special manipulations such as aliquots, irradiation, thawing, and pooling could be included if appropriate. All policies, procedures, accreditation and regulatory requirements are provided by the Carter BloodCare main facility.

Limited on-site transfusion services are also available as an additional model based on facility need. The patient sample would be collected at the facility and shipped to Carter BloodCare. The laboratory will perform all in-house transfusion services testing & provision of blood (as addressed above). There would be a staff member and limited equipment on-site in the facility. When possible, the lab will electronically crossmatch unit(s) available in stock in the refrigerator located on-site in the facility for the patient. The on-site staff member will be responsible for tagging these units, making them available for transfusion, rotating the inventory to prevent outdates, providing emergency release blood and issuing the compatible blood products needed by the facility during normal operating hours.

If interested in using Carter BloodCare for Transfusion Services, please contact us at either 817-412-5128 (BJ Smith) or 817-412-5271 (Sandy Wortman), and we can discuss which arrangement would work best for your facility.

Immunohematology Reference Laboratory

The Immunohematology Reference Laboratory (IRL) located in Bedford, Texas is one (1) of two (2) AABB accredited IRL laboratories in the state of Texas, one (1) of six (6) AABB accredited IRL laboratories in the region (Texas, Louisiana and Oklahoma), and one (1) of sixty-one (61) AABB accredited IRL laboratories in the nation. The laboratory performs the following services:

  • Remote transfusion services (Crossmatch Account Services), full service on-site transfusion services and limited on-site services – refer to above section Transfusion Services.
  • Reference services (including, but not limited to):
    • Detection of unexpected antibodies and compatibility (crossmatching) testing.
    • Simple to very complex antibody identifications using various techniques (including, but not limited to):
      • Techniques: Tube (LISS, PeG, Saline, Albumin), Gel, and Solid Phase (ECHO)
      • Enzymes (Ficin, Bromelin, Chloroquine, EGA, DTT, ZZAP)
      • Elutions (Lui Freeze Thaw, Landsteiner-Miller Heat or Low pH)
      • Adsorptions (REST, Autologous, Allogeneic, and Differential)
      • Titration studies (Routine, High Frequency Antibodies, Cold Agglutinin & Isohemaglutinins)
      • Cold Agglutinins and WAHIA Studies
      • Special Techniques:
        • Molecular genotyping of RBCs
        • Saline replacement
        • Acidification of serum
        • Neutralizations
        • Harvesting autologous RBCs
        • Donath-Landsteiner
        • Drug studies
        • Polyagglutination studies
        • IgG Blocking
        • Thermal amplitude testing.
      • Participation in the national SCARF program.
  • Provision or antigen negative units (confirmed, historical or molecular matched) for patients.
    • Use of the facility’s large stock of rare reagent cells and antisera for resolving work-ups
    • Access to an extensive inventory of antigen negative units onsite, including frozen red cells
    • Fresh units of RBCs automatically put aside by the facility computer if they have known desirable phenotypes
    • Ability to call donors on demand to meet patient needs for unused blood types
    • Participation in the national American Rare Donor Program (ARDP) Refer below to ARDP section
  • Modified workups & phenotypically matched RBCs for eligible chronically transfused patients.
  • Provision of specialty products (Reconstituted Whole Blood, Granulocytes, Washed/additive-reduced/deglycelolized RBCs).
  • Assist in the investigation and management of transfusion complications (transfusion reaction workups).
  • Platelet services (crossmatch, antibody screening, HPA-1a negative and/or HLA matched platelets).
  • Molecular genotyping for red cell antigens in both patient and donor samples
    • Includes sending out samples for RHD variant testing, RHCE variant testing, allele sequencing testing, and discrepancy workups, as appropriate.
  • Referral Testing
    • Mononuclear Monocyte Assay (MMA) Testing & IgG Classification
    • TRALI Investigations (Neutrophil Serology)
    • Gram Stain & Culture (transfusion reaction investigation)
  • Consultation Services with experienced R&T staff (MT/BB/SBB) and/or Medical Directors (MD) 24/7
  • Donor Testing
    • Positive for unexpected antibody resolutions (IAT)
    • Discrepancies results (DAT & ABO/Rh)
    • Walk-in Donor ABO/Rh
    • Antigen phenotyping (Molecular & Serology) to expand our donor antigen history database and identify rare blood group phenotypes.
    • HPA-1a and HLA testing to expand our donor database
  • Assistance with clinical trials and research projects.

IRL American Rare Donor Program

The Carter BloodCare IRL proudly participates in providing and procuring rare blood through nationwide searches by the American Rare Donor Program (ARDP) to ensure all patients receive the blood they need throughout the nation. The ARDP was established in 1998 and assists in providing rare units throughout the US and the international community.

When the need for a rare unit(s) cannot be met locally or regionally, the ARDP is notified and sends out a national search notice. A Blood Center that can meet the needs notifies ARDP or the designated facility to arrange shipment. If a Carter BloodCare donor meets the established qualifications of a “rare” donor, they are notified by the ARDP via Carter BloodCare and can choose to accept or decline participation in the ARDP program. If you are interested in the requirements to be an ARDP donor please contact the Carter Bloodcare IRL.


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