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26664 Neonatal Direct Antiglobulin Testing

Neonatal Direct Antiglobulin Testing
Test Code: NEO DAT
Synonyms/Keywords

​​​Direct Coombs, DAT, Coombs Test, Direct Antiglobulin Test

Test Components

​DA​T IgG

Useful For

​​When fetomaternal ABO incompatibility exists, potential for ABO Hemolytic Disease of the Fetus and Newborn (HDFN) exists. This test may be useful in investigation of suspected HDFN. RBCs obtained directly from the patient are washed free of unbound globulins and tested against monospecific Antihuman globulin (AHG) reagents (Anti-IgG). Agglutination by a monospecific reagent suggest that the RBCs are coated with the corresponding globulin.

Specimen Requirements
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)		Pediatric Minimum Volume
(no repeat)
​No
​Whole Blood
​EDTA Lavender Top Tube (LTT)
​whole blood microcollection tubes (EDTA)
​3 mL
​1 mL
​Two 0.5 mL tubes
Acceptable Specimen Types

​Whole Blood​

Specimen Stability Information
Specimen TypeTemperatureTime
​Whole Blood
​Refrigerate
​<48 hours old
Rejection Criteria

Frozen, Hemolyzed, Serum Separator Tubes (SST), Specimens >48 hours old

Interference

​Some drugs may cause antibody formation, which can lead to a positive DAT, with or without immune hemolysis by one of four mechanisms. Monospecific DAT results may help classify the type of drug mechanism occurring. Drugs known to cause a positive DAT or immune hemolysis can be compared to patients medications to explain unexpected DAT results.  ​

Performing Laboratory Information
Performing LocationDay(s) Test PerformedAnalytical TimeMethodology/Instrumentation
​Beaver Dam
​Monday through Sunday
​Less than 2 hours
​Gel
Eau Claire
​Monday through Sunday
​Less than 2 hours
​Serological
​Marshfield
​Monday through Sunday
​Less than 2 hours
​Serological
​Rice Lake
​Monday through Sunday
​Less than 2 hours
​Serological
​Weston
​​Monday through Sunday​
​Less than 2 hours​
​Serological​
Test Information

​Direct antiglobulin testing is used in the investigation of immune-mediated RBC destruction when IgG may be bound to RBCs in vivo. Neonates are defined as infants from birth to less than 4 months of age. 

Reference Range Information
Performing LocationReference Range
All Performing Sites​
​Negative​
Interpretation

​Neonates <4 months: Specimen is tested with monospecific IgG. The DAT is performed to determine if maternal antibody is coating the newborn red cells. If DAT is positive, an antibody elution may be performed and charged based on maternal antibody history. 

Outreach CPTs
CPTModifier
(if needed)		QuantityDescriptionComments​
​86880
​​1
​DAT IgG​
​
Synonyms/Keywords

​​​Direct Coombs, DAT, Coombs Test, Direct Antiglobulin Test

Test Components

​DA​T IgG

Ordering Applications
Ordering ApplicationDescription
Cerner​
​Neonatal ABO/RH​
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)		Pediatric Minimum Volume
(no repeat)
​No
​Whole Blood
​EDTA Lavender Top Tube (LTT)
​whole blood microcollection tubes (EDTA)
​3 mL
​1 mL
​Two 0.5 mL tubes
Acceptable Specimen Types

​Whole Blood​

Specimen Stability Information
Specimen TypeTemperatureTime
​Whole Blood
​Refrigerate
​<48 hours old
Rejection Criteria

Frozen, Hemolyzed, Serum Separator Tubes (SST), Specimens >48 hours old

Interference

​Some drugs may cause antibody formation, which can lead to a positive DAT, with or without immune hemolysis by one of four mechanisms. Monospecific DAT results may help classify the type of drug mechanism occurring. Drugs known to cause a positive DAT or immune hemolysis can be compared to patients medications to explain unexpected DAT results.  ​

Useful For

​​When fetomaternal ABO incompatibility exists, potential for ABO Hemolytic Disease of the Fetus and Newborn (HDFN) exists. This test may be useful in investigation of suspected HDFN. RBCs obtained directly from the patient are washed free of unbound globulins and tested against monospecific Antihuman globulin (AHG) reagents (Anti-IgG). Agglutination by a monospecific reagent suggest that the RBCs are coated with the corresponding globulin.

Test Components

​DA​T IgG

Reference Range Information
Performing LocationReference Range
All Performing Sites​
​Negative​
Interpretation

​Neonates <4 months: Specimen is tested with monospecific IgG. The DAT is performed to determine if maternal antibody is coating the newborn red cells. If DAT is positive, an antibody elution may be performed and charged based on maternal antibody history. 

For more information visit:
Performing Laboratory Information
Performing LocationDay(s) Test PerformedAnalytical TimeMethodology/Instrumentation
​Beaver Dam
​Monday through Sunday
​Less than 2 hours
​Gel
Eau Claire
​Monday through Sunday
​Less than 2 hours
​Serological
​Marshfield
​Monday through Sunday
​Less than 2 hours
​Serological
​Rice Lake
​Monday through Sunday
​Less than 2 hours
​Serological
​Weston
​​Monday through Sunday​
​Less than 2 hours​
​Serological​
For billing questions, see Contacts
Outreach CPTs
CPTModifier
(if needed)		QuantityDescriptionComments​
​86880
​​1
​DAT IgG​
​
For most current information refer to the Marshfield Laboratory online reference manual.