Requisition, Sample Collection, and Shipping HEMOSTASIS This package includes information for the requisition of research assay tests performed by the Red Blood Cell Laboratory. For questions, please contact: Sandra Larkin Phone: (510) 450-7621 Fax: (510) 450-7910 Email: RBC [email protected] Page 2: Requisition form Please complete the requisition form and include it with samples shipped appropriately (see page 3). Visit www.rbclab.com for detailed information on the tests provided. Page 3: Sample collection, processing, and shipping Please carefully read the sample collection and shipping instructions on page 3, and label the collection tubes clearly. Indicated in the table below are the tests of the analytes in different media. For tests on plasma or serum, blood can be separated locally, labeled, and stored at -80°C until enough samples are collected to make shipping on dry ice economical. Similarly, urine can be shipped in batches. Please contact us to discus such details. D-Dimer (DD) Fragment 1+2 (F12) Thrombin-Anti Thrombin (TAT) Tissue Factor (TF) Serum Plasma X X X PPP X X 1 RBC LAB REQUISITION FORM HEMOSTASIS This form must accompany each sample set and must be completed fully in order for samples to be processed! Study Name and Number: _____________________________________________ Attach a hard copy of the list of samples to this form (including all of the information on the tube labels): Sample Name, sample ID#, date drawn, assay. Send excel file by email. Check all that apply:  DD  F12  TAT  TF Name of Requesting Institution: _______________________________________ ____________________________________________________ Address: ____________________________________________________ ____________________________________________________ ____________________________________________________ Physician or Prinicpal Investigator:_____________________________________ Phone#: __________________________Fax#: _____________________________ Email: _____________________________________________________________ Study Coordinator: __________________________________________________ Phone#: __________________________Fax#: _____________________________ Email: _____________________________________________________________ RBC lab use only Date/Time received: _________________________________ Date/Time processed: ________________________________  Inappropriate storage, delivery, or containment Explain:____________________________________  Requisition form incomplete 2 Sample Collection Requirements - HEMOSTASIS Serum: Collection / Container / Volume: Collect a 2-5 ml blood sample by routine venipuncture into a serum separator tube (red top or tiger top tubes). Store 0.5 ml serum aliquots in 1 ml cryovials. Labeling: please include a sample ID# and date/time drawn on each vial. Processing: After allowing sample to clot for 30 minutes, centrifuge for 5 minutes at 1000 x g. Remove serum and store at 2-8oC for assay within 24 hours or aliquot and store samples frozen (preferably at -80oC, then the stability is at least 1 year). Grossly hemolyzed samples are not suitable for measurement. Plasma: Collection / Container / Volume: Collect a 2-5 ml blood sample by routine venipuncture into a vacutainer containing any of the following anticoagulants: EDTA, heparin, or citrate. Store 0.5 ml plasma aliquots in 1 ml cryovials. Labeling: please include a sample ID# and date/time drawn on each vial. Processing: Specimen must be centrifuged for 5 minutes at 1000 x g within 30 minutes of collection. Remove plasma and store at 2-8oC for assay within 24 hours or aliquot and store samples frozen (preferably at -80oC, then the stability is at least 1 year). Grossly hemolyzed samples are not suitable for measurement. Avoid repeated freeze/thaw cycles. Platelet Poor Plasma (PPP): Collection / Container / Volume: Collect a 2-5 ml blood sample by routine venipuncture into a vacutainer containing trisodium citrate (blue top tube). Store 0.5 ml PPP aliquots in 1 ml cryovials. Labeling: please include a sample ID# and date/time drawn on each vial. Processing: Specimen must be centrifuged for 15 minutes at 1000 x g within 30 minutes of collection. Remove plasma and store at 2-8oC for assay within 24 hours or aliquot and store samples frozen (preferably at -80oC, then the stability is at least 6 months). Grossly hemolyzed samples are not suitable for measurement. Avoid repeated freeze/thaw cycles. Transport: Ship batches on dry ice by overnight shipping. Shipping: Sandra Larkin, RBC Lab, Room 1114 Children’s Hospital Oakland Research Institute 5700 Martin Luther King Jr. Way Oakland, CA 94609 3