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Select department: Select...AllAnatomical PathologyBiochemistryBlood BankCoagulationCytopathologyFlow CytometryHaematologyImmunologyMicrobiologyReferred TestSpecial HaemostasisSpecimen CollectionUnassigned
Recent changes for ADAMTS-13 Activity Assay
If you are uncertain about the appropriate signatory for the non-rebatable form, please contact extension 22004 or 54605 for clarification.
Specimen should reach the laboratory ASAP.
Recent changes for Adenovirus PCR
Tissue
TissueBlood
Swab - white top, plain swab, plastic shaftFaeces-plain potSterile Jar
Swab - white top, plain swab, plastic shaftFaeces-plain potSterile JarEDTASerum tube with gel
For blood samples, can be shared with other Micro PCR tests (eg CMV viral load)
Recent changes for Aldosterone - blood
Collection Requirements for both or either tests
Collect into 4 mL EDTA tubes at Room Temperature. Do not collect on ice
If both Renin and Aldosterone are requested together, they can be collected into the same EDTA tube
Whole blood or plasma stored at 4 Deg C is not suitable
Add-on tests for Aldosterone can be done on samples which have been previously collected and stored at 4 Deg C, for 4 days.
Collection Requirements
Collect into 4 mL EDTA tubes at Room Temperature. Do not collect on ice.
If both Renin and Aldosterone are requested together, they can be collected into the same EDTA tube.
If Aldosterone and cortisol are requested together (but not renin), then these can be collected in the same EDTA tube, or the same serum tube.
Whole blood stored at 4 Deg C is not suitable, separated plasma may be suitable.
Add-on tests for Aldosterone can be done on serum samples which have been previously collected and stored at 4 Deg C, for 4 days.
aldosterone alone is not appropriate as an initial investigation. Used as part of protocols available on consultation
Serum/Plasma aldosterone has substantial physiological variation and interpretation may be difficult.
Plasma renin activity is a more useful initial test in the evaulation of hypertension.
Aldosterone alone is not appropriate as an initial investigation. Used as part of protocols available on consultation.
Plasma renin is a more useful initial test in the evaulation of hypertension.
Add-on tests for Renin and Aldosterone should not be done on samples which have been previously collected or stored at 4 Deg C
Referred Test
Biochemistry
In the laboratory, spin and separate the plasma immediately. Plasma is stable at Room Temperature if analysis is performed on the same day
If the specimen arrives on the weekend or after hours, or if the specimen is referred from an external laboratory, freeze the plasma
EDTA plasma samples from external laboratories should be stored and transported frozen
If the specimen arrives on the weekend or after hours freeze the plasma
Austin Pathology
Recent changes for Alpha-1 Antitrypsin - Quantitation
Sample must be frozen within 48 hrs of collection
Recent changes for Anti-Heart Antibodies
Pathwest Lab Med WA
Recent changes for Anti-Myocardial Antibodies
Recent changes for Aspergillus precipitins
Twice weekly
Weekly
Immunodiffusion for Aspergillus fumigatus antibodies in allergic Aspergillosis.
Test for Aspergillus fumigatus antibodies.
Monash Pathology
Test performed by Royal North Shore Hospital, NSW
Sent with ICPMR courier
Recent changes for Beta-Hydroxybutyrate
Ketones (Blood)
Beta-Hydroxybutyrate
Unassigned
1 mL
Transport ON ICE IMMEDIATELY to lab
Take test before correcting hypoglycaemia. Take concurrently with formal glucose, and, ideally, C-peptide. Consider other relevant tests that might be required (e.g. Growth hormone, ACTH)
Daily
Recent changes for Bilirubin, Conjugated
As of 04/02/2025 assay no longer performed at Angliss Laboratory. Samples are to be sent to Box Hill via internal courier. Outside this schedule samples can wait except neonatal samples that must be taxied to Box Hill as urgent.
Samples are to be sent to Box Hill via internal courier. Outside business hours, neonatal samples must be taxied to Box Hill as urgent.
Recent changes for C Peptide
Fasting specimen required, deliver Immediately to the lab.
Deliver Immediately to the lab.
Recent changes for Caeruloplasmin
Sample required to be frozen within 48 hrs of collection
Recent changes for Cholesterol, Low Density Lipoprotein
LDL is not measured directly, but is calculated using the Friedwald formula:
(LDLC) = (total CHOL) - (HDLC) - (TG/2.2)
This formula cannot be used where TG > 4.5 mmol/L
LDL was previously calculated from triglyceride, cholesterol and HDL cholesterol using the Friedewald formula.
As from 22nd of February 2024, LDL is calculated using the Sampson equation. Friedewald knew that with increasing triglyceride levels, the calculated LDL-C was progressively falsely lower when compared with the gold standard technique and therefore Friedewald stated LDL-C should not be calculated when triglycerides are > 4.5 mmol/L. With much lower LDL-C levels seen in the statin era, an improved calculation was required, hence the Sampson equation.
Comparing both equations with the gold standard ultracentrifugation method, Sampson LDL-C offers similar or better accuracy than Friedewald LDL-C at any triglyceride level. Sampson LDL-C can also be calculated up to a triglyceride level of 9 mmol/L.
Friedewald: LDL-C = TC – HDL-C – Triglycerides/2.2
Sampson: LDL-C=TC/0.948−HDL-C/0.971−(TG/8.56+TG × non-HDL-C/2140 −TG2/16100)−9.44
The calculation for the Sampson equation is complicated but Friedewald LDL-C can be (easily) calculated from the available lipid results if required.
Recent changes for CMV Viral Load
This test cannot be performed on the same specimen as for an FBE. A separate EDTA tube is required.
<400 copies per ml can be detected but will be reported without specific quantity
Contact VIDRL 9342 9628
This test can be performed on same sample as other Micro PCR tests (eg EBV PCR, polyomavirus viral load). If unsure, contact Microbiology lab before organising any recollections
Recent changes for Cold Agglutinins
Pre heated 6 mL EDTA tube. Tubes,needles and syringes must be pre-warmed at 37oC and specimen placed into a hot box (obtained from the laboratory) and transported to the laboratory immediately. Cold specimens may give erroneous results.
Collect a Hot Box with 2x pre-heated, 6 mL EDTA tube from Pathology Specimen Reception. Sample collection must occur within 10min. Once samples are collected, transport to the laboratory immediately.
Cold specimens may give erroneous results.
Specimen must be allowed to settle in 37°C incubator (tubes must NOT be allowed to cool to RT prior to separation). Once seperated, can be stored according to laboratory protocols.
Specimens must be handed to Blood Bank Scientist immediately to place in their waterbath. Please do not leave in the rack.
Once plasma is separated, transportation and storage can be at 4°C.
Angliss and Maroondah lab: Once plasma is separated, transportation and storage can be at 4°C.
Mon-Fri
Investigation of cold agglutinin specificity, thermal range and titre by consultation with Haematologist
Tubes warmed to 37oC are available from Blood Bank laboratory, Box Hill.
Test performed during business hours.
Test performed during business hours, Monday to Friday.
N/A mL
CAGS
CAGG
Blood Bank
5 mL
Serum No Gel & EDTA
Pink EDTA (6mL)
Pre heated 4 mL EDTA tube and 10 mL plain tube. Tubes,needles and syringes must be pre-warmed at 37oC and specimen placed into a thermos flask ( obtained from the laboratory) and transported to the laboratory immediately. Cold specimens may give erroneous results.
Specimen must be centrifuged and separated immediately upon receipt (tubes must NOT be allowed to cool to RT prior to separation)
Once plasma is separated, transportation and storage can be at 4 degrees.
As required
Tubes warmed to 37oC are available from the Core laboratory
Recent changes for Copeptin
Transport specimen at Room Temperature to lab
Recent changes for Copper - Blood
Plasma
Serum
Trace metal tube ( Dark blue )
Serum tube with gel
Alfred Hospital
Royal Childrens Hospital
Spin and separate plasma into a yellow top PP tube.
Pipettes cannot be used to transfer plasma.
Recent changes for Copper - Urine
Do not aliquot sample. Weigh the container/contents. Send the primary urine bottle to RCH.
Do not aliquot sample. Weigh the container/contents Note the bottle weight and the volume. Send the primary urine bottle to RCH.
24 hour urine directly into a special nitric-acid washed container available from the laboratory. Please DO NOT use a standard 24 hour urine container.
Patient Collection Instructions
24 hour urine directly into a special HCL acid washed container available from the laboratory. Please DO NOT use a standard 24 hour urine container.
Send whole container to Austin Pathology. Do Not aliquot.
Recent changes for Creutzfeldt-Jakob Disease
Requests for Alzheimer's disease - CSF must be collected in a seperate blue capped PP tube, available from Pathology Specimen Reception (CSR).
DO NOT CENTRIFUGE SPECIMEN
This test requires authorisation by the Neurology Registrar or Neurology Consultant.
CSF Specimens are unsuitable for testing if macroscopically haemorrhagic, xanthochromic, have red blood cell counts < 500/uL, have white cell counts < 10/uL
CSF Specimens are unsuitable for testing if macroscopically haemorrhagic, xanthochromic. Cell count must have red blood cell counts < 500/uL, and white cell counts < 10/uL
In addition, please refer to Eastern Health Infection Control CJD procedure and contact Infection Control prior to performing the Lumbar Puncture
Test is run weekly. Samples received by 4 p.m. Friday will have the result issued by the end of the following week.
CSF : Tests for 14-3-3 CSF protein
At least 1 mL of CSF is required in a separate (4th), unopened tube.
Double bag specimen. Must be frozen and transported on dry ice.
Blood : Test for PRNP (Prion protein gene)
5 mLs in EDTA tube
Double bag specimen. Note: sample is no longer required to be sent frozen.
Recent changes for Cryoproteins - Blood
PLEASE NOTE : One EDTA (purple top) and one Plain serum (red top) tube MUST BE COLLECTED. All samples must be kept at 37oC in a thermos flask and delivered to the laboratory immediatley. Both tubes are required for Cryoprotein analysis.
Heated specimen tubes in thermos flask can be obtained from the laboratory.
Collection: Monday to Friday (public holidays excluded) during the following times only:
Box Hill: 4am-4pm
Maroondah and Angliss: 4am-1:30pm
The test must be collected using a "cryoglobulin collection kit at 37°C", which is obtained from the laboratory. The kit contains pre-warmed 9 mL serum no-gel tube and 4 mL EDTA tube.
The flask must be tightly closed at all times except for when removing and returning tubes. Do not remove the gel pack from the flask. Immediately post collection, the tubes are inserted into the insulating “socks”, returned to the warm flask (37°C), and transported back to the laboratory. The specimens MUST be correctly labelled. The flask must be returned to the specimen reception/laboratory within 60 minutes of obtaining it.
Keep the sample in the incubator for 1 hour. Spin and separate serum and plasma into marked aliquot tubes and send at RT.
Return the samples to the 37°C incubator immediately.
Maroondah and Angliss: DO NOT centrifuge samples. Transfer tubes to a pre-warmed flask and send with the courier to Box Hill (remove from the incubator only when the courier arrives).
Box Hill: Inform the proteins lab scientist of the sample. They will centrifuge and aliquot.
Further instructions see WORK-CHEM-29
Recent changes for Cryptococcal Antigen
Both CSF & Serum tests performed in Microbiology.
Both CSF & Serum tests will get performed in Microbiology lab.
Recent changes for CSF BioFire Meningitis/Encephalitis Panel
This test required approval from the Clinical Microbiologist. Minimum 200uL/0.2mL of unspun CSF is required for this test.
CSF collected via lumbar punture only; bloodstained/xanthochromic samples are suitable
NOTE: Non-K1 E. coli serotypes may be present in a specimen and will not be detected by the BioFire ME Panel. NOTE: Non-encapsulated strains of Neisseria meningitidis are not detected by the BioFire ME Panel. NOTE: The BioFire ME Panel does not distinguish between latent and active CMV and HHV-6 infections. Detection of these viruses may indicate primary infection, secondary reactivation, or the presence of latent virus. Results should always be interpreted in conjunction with other clinical, laboratory, and epidemiological information. NOTE: Patients with a suspicion of cryptococcal meningitis and a negative cryptococcal PCR result, such as by the BioFire ME Panel, should be tested for CrAG.
Recent changes for D-Dimer
D Dimer, DDimer, Fibrin breakdown products
D Dimer, DDimer
Recent changes for EBV Viral load
Send to VIDRL. Contact 9342-9628
This test can be performed on same sample as other Micro PCR tests (eg CMV viral load/PCR, polyomavirus viral load). If unsure, contact Microbiology lab before organising any recollections
Recent changes for Faecal Calprotectin
For non-rebatable tests the out of pocket cost is $60
Sample must be a dedicated collection and be frozen at -20 upon recipept at the laboratory. Sample is stable for 3 days at 2-8 degrees.
For non-rebatable tests the out of pocket cost is $75
Recent changes for Faecal Occult Blood
The 3 specimens should collected at 3 different times. Register on 3 lab numbers.
The 3 specimens should collected at 3 different times.
All three samples from a single patient need to be registered under only one episode number. Please label three tubes with the same container label.
Recent changes for Fluids - for Cell Count And Culture
Ascitic, Pericardial, Synovial/Joint and Pleural Fluid.
Specimen should be collected in a sterile container(s). These fluids are often clotted on arrival and only a qualitative count and Gram stain are performed.
For cell counts, an EDTA tube is required
For Cytology see Anatomical Pathology Laboratory - Cytology Service
If Cytology is the primary pathology test requested for malignancy testing a bag of fluid may be sent in addition to the 50ml containers. Bags of fluid must be transported to the laboratory in buckets. Buckets are available from Theatre or Pathology. Collect bucket prior to transporting fluid.
Transport as soon as possible to the laboratory as cells rapidly deteriorate. Specimens for cytology therefore should be transported at 2-8oC. Fluids only for microbiology may be transported at room temperature.
NB: negative pressure drainage units (atrium drain, Oasis) are NOT suitable for Microbiological investigations. An appropriately collected fluid should be sent. These samples are only suitable for Cytology investigations.
Recent changes for GAAD
BMISC
PIVKA
Recent changes for Gastrin
Sydney South West Pathology Service(RPA)
Dorevitch Pathology
St Vincents Hospital
Recent changes for Haemophilus ducreyi culture
chancroid
Genital swab kit
Swab - blue top (Amies transport media)
Genital swab collected in transport medium required. Discuss with Microbiology laboratory prior to collection.
Genital swab collected in transport medium required (orange top charcoal swab and/or blue top amies gel swab). If this test is required, contact the Clinical Microbiologist via switchboard to discuss. Discuss with Microbiology laboratory prior to collection.
Send to Melbourne Sexual Health Centre
580 Swanston St
Melbourne
Phone 9341 6220
Organism confirmation will be done by MDU
?Send to Melbourne Sexual Health Centre
Organism confirmation will be done by MDU.
No PCR test available
Recent changes for Helicobacter pylori Breath Test
Arrangements can be made through Microbiology, Monash Medical Centre
Recent changes for Helicobacter pylori Serology
Victorian Infectious Diseases Reference Laboratory (V.I.D.R.L)
Contact VIDRL 9342 2649/9342 2650.
Recent changes for Hepatitis B serology
core IgM, e markers, Hep B e serology, Hep B serology
core IgM, e markers, Hep B e serology, Hep B serology, HBVL
Recent changes for Hepatitis Serology
Virus/Test
Test codes Ordered
Notes
Hepatitis A
Hepatitis A IgM
HAM
For acute Hep A
Hepatitis A total
HAV
For previous infection/vaccination
Hepatitis A PCR
HEPAR
Hepatitis B
Hepatitis B surface antigen
HBSAG
For acute infection
Hepatitis B surface antibody
HBSAB
For vaccination status
Hepatitis B core antibody
HBCORA
For previous Hep B infection
Hepatitis B core IgM
HBCORM
Hepatitis B “e” antigen/antibody
HEPBE
For Hep B monitoring
Hepatitis B viral load
HBVL
Hepatitis C
Hepatitis C antibody
HEPC
For Hep C status (acute or chronic)
Hepatitis C PCR
HEPCR
Hepatitis C viral load
HEPCVL
Hep C monitoring
Hepatitis C genotype
HEPCG
Hepatitis D
Hepatitis D antibody
HEPDAB
Hepatitis D status
Hepatitis D PCR
HEPDR
Hepatitis E
Hepatitis E antibody
HEPEG
Hepatitis E status
Hepatitis testing – Which test to order?
1. Principles of hepatitis testing
Consider the incubation periods:
Hepatitis A: 2 - 6 weeks
Hepatitis B: 1 - 6 months
Hepatitis C: 15 days - 5 months
Types of antibodies:
IgM is detected in recent infection and lasts for about 3 months
IgG alone occurs with past infection, carrier states and vaccination
IgM & IgG occur together in recent infection
2. The jaundiced patient - ?Acute (infectious) hepatitis
Is this Hepatitis A, B or C?
Also consider:
EBV, CMV
Non-infectious causes of jaundice (biliary obstruction, medications, alcohol)
3. Testing for acute hepatitis
HBsAg (hepatitis B surface antigen)
If HBsAg detected, request HBcIgM (hepatitis B core IgM antibody - usually present at onset of symptoms).
HAV IgM
Occurs with onset of abnormal LFTs
HCV Ab / Anti-HCV
Present at onset of symptoms in 50 -70% patients
Occurs by 20 weeks in 95% patients
If negative early, repeat if no other cause found
4. Antenatal hepatitis screen
HBsAg - To detect maternal chronic hepatitis B infection (‘carrier’)
(HCV antibody only if requested)
5. Post Vaccination Check
Hepatitis B vaccination
Check HBsAb (Anti-HBs, hepatitis B surface antibody)
Timing: 4 weeks after 3rd vaccination
If negative, consider checking for HBsAg (hepatitis B surface antigen) carriage
Hepatitis A vaccination
Anti-HAV Total antibody
Note - There is no hepatitis C vaccination available currently
6. Blood or body fluid exposure (eg. needlestick injury / mucosal splash)
Source (eg. patient):
HBsAg, HCV Ab (Anti-HCV), HIV Ab (Anti-HIV)
Recipient (eg. healthcare worker):
HBsAb (Anti-HBs) + baseline LFTs if ‘Source’ hepatitis serology positive
Store serum for 2 years
7. Possible hepatitis B ‘carrier’ (chronic hepatitis B infection)
Check HBsAg
If HBsAg detected then check - HBeAg and HBeAb (Anti-HBe) - HBV DNA
8. Possible chronic hepatitis C infection
Check HCV Ab (Anti-HCV)
If detected, then check Hep C PCR
9. Tests for patients at risk of blood borne viruses
If negative check HBcAb (Anti-HBc, hepatitis B core antibody) for previous infection
If detected check HBeAg, HBeAb (Anti-HBe) & HBV DNA to assess infectivity
HCV Ab (Anti-HCV): If detected, check Hep C PCR
Anti-HAV Total antibody: If at risk of hepatitis A prior to immunisation (eg injecting drug users, men who have sex with men).
10. GLOSSARY
Call the Core Laboratory 9895 3471 and speak to the Senior Scientist.
Compiled by Dr Mary O'Reilly, Head of Eastern Health Infectious Diseases & Infection Control.
ACHEP
see table below
Recent changes for Herpes Virus PCR
0.3 mL
0.2 mL
Test performed is a multiplex PCR for the following viruses: Herpes simplex 1 virus (HSV-1); Herpes simplex 2 virus (HSV-2); Varicella zoster virus (VZV); Cytomegalovirus (CMV); Enterovirus (EV); human Adenovirus (hAdv). Swabs and CSF samples are performed in-house at Box Hill laboratory, other sample types are referred.
CSF minimum volume for testing: 200uL/0.2mL
CMV PCR, HSV, HSV I-II, HSV PCR, VZV and CMV NAD, VZV PCR
CMV PCR, HSV, HSV I-II, HSV PCR, VZV and CMV NAD, VZV PCR, Enterovirus PCR, Adenovirus PCR
Microbiology
HPCR
HPCR, (ENTPCR, ADEPCR)
Cerebrospinal FluidFluidTissueNasopharyngeal swabBlood
SwabCerebrospinal FluidTissueNasopharyngeal swabRespiratory samples
Respiratory samples
Blood
Tests included in Monash PCR - Herpes simplex 1 virus, Herpes simplex 2 virus, Varicella zoster virus, Cytomegalovirus, Enterovirus (swabs only), Adenovirus (not faeces)
Specimens tested at Monash-
Swabs (dry or in UTM), Sterile fluids, Respiratory samples, Urine.
Specimens anticoagulated with heparin are unsuitable as heparin inhibits PCR
For other specimens - refer to VIDRL. Tissue, CSF, saliva, serum, Plasma (ACD or EDTA),
If CSF Herpes and Enterovirus PCR -send to VIDRL.
Refer to Referred Molecular Test Requests WORK-MI-90
Specimens tested at Box Hill - Swabs (dry or in UTM), CSF
Specimens from other sites are referred to VIDRL for testing.
Contact Monash Pathology 9594 4532 or if no answer try Bacteriology 9594 4565 as there is someone rostered 24/7
Tested M, W, F
Routine runs are performed Monday and Thursday. Additional runs for urgent CSF samples are perfomed after discussion with the Clinical Microbiologist.
This test detects Herpes Simplex Virus 1(HSV-1), Herpes Simplex Virus 2 (HSV-2), Varicella zoster virus (VZV) and Cytomegalovirus (CMV).
Recent changes for Histopathology
During Business Hours: all Fresh Tissue for histopathology must be brought to the attention of an Anatomical Pathologist in the first instance. After Hours: All Fresh Tissue specimens (with the exception of “products of conception” – including placenta) the on-call Pathologist must be contacted for further instructions. Products of conception including placenta can be stored in the fridge until the next working day.
During Business Hours (0800-1630hours): ALL Fresh Tissue for histopathology must be brought to the attention of an Anatomical Pathologist in the first instance by the receipting/accepting laboratory. After Hours: All Fresh Tissue specimens (with the exception of “products of conception” – including placenta) the on-call Pathologist must be contacted for further instructions. Products of conception including placenta can be stored in the fridge until the next working day.
Recent changes for Kleihauer stain
Kleihauer test
Kleihauer test, FMH (feto-maternal Haemorrhage)
KL
FMH
Recent changes for Lactate
LAC
LAC, CSFLACT
PlasmaCerebrospinal Fluid
Fluoride/oxalate tube (grey)
Fluoride/oxalate tube (grey)CSF
Keep specimen on ice, transport to testing lab within four (4) hours.
Preferred tube - fluoride/oxalate (grey topped vacuum tube)
NB: specimens collected in this tube are unsuitable for most other tests.
Acceptable tubes - Blood in a blood gas syringe, packed in ice and delivered within five minutes of collection.
Serum is NOT an acceptable sample.
CSF performed as requested on a CSF collection
Recent changes for Leucocyte Immunophenotyping
Sample store at Room temperature. Samples are not stable for more than 24 hours. Hence they must be received by the Flow Cytometry lab at Box Hill within normal business hours Monday to Friday.
Cut-off for outpatient sample collection on Fridays is at 11.30 AM and MUST reach the laboratory before 2.00PM.
The panel of markers used will be appropriate to the panel selected and the clinical comments supplied , or as arranged by prior consultation
Sample store at Room temperature.
Blood samples for oncology phenotyping should preferably be maintained at room temperature on the day that they are collected, but if not processed that day, refrigeration for up to 48-72 hours is also acceptable.
Recent changes for Lymphocyte subsets
Recent changes for Malarial Parasites
Thick and Thin films
Malaria parasite investigation Thick and Thin films
Clinical history including details of overseas travel and prophylaxis required
An FBE is performed at the same time
ICT test (rapid whole blood immunochromatographic test) for the qualitative detection of Plasmodium falciparum and Plasmodium vivax antigens is performed in addition to microscopic examination.
Recent changes for Measles virus PCR
Notify Microbiology/Molecular staff of ANY Measles PCR request between 07:00 - 01:30 7 days a week.
These requests may require urgent taxi transfer to reference lab, and samples need to arrive early to ensure results are available. Microbiology are also required to notify the Dept. of Health, and so need to be made aware of the request.
Note: out of hours testing is not routinely performed, and only under the direction of the Dept. of Health.
Recent changes for Mpox PCR
Contact MIcro lab if other samples types received. Do not KIMMS first
Contact Micro lab if other samples types received. Do not KIMMS first
SwabTissue
SwabTissueUrine
Swab - white top, plain swab, plastic shaftSterile Jar
Swab - white top, plain swab, plastic shaftSterile JarUrineSwab - blue top (Amies transport media)Viral Transport Media - Nasopharyngeal
Recent changes for Muscle Biopsy
Note: This is an URGENT send out test.
Laboratory hours are 9am - 3pm, Monday - Friday.
Specimen must arrive at Alfred Pathology by 4pm.
Laboratory hours are 9am - 5pm, Monday - Friday.
Specimens need to be delivered to Leve4 Specimen Reception by 3pm as the specimen must arrive at Alfred Pathology by 4pm.
Recent changes for Neonatal Blood Group Serology
Neonatal Group & DAT Neonatal Group, Screen and DAT
BGN
BGN, GPHN
Cord blood or heelprick collection required
Must be accompanied by a Blood Bank request form with the declaration signed, timed and dated. The blood tube must also be signed, dated and timed; matching the request slip exactly.
Includes Neonatal ABO & Rh(D) Blood Group and Direct Coombs TestCord blood or heelprick collection required
Includes Neonatal ABO & Rh(D) Blood Group and Direct Coombs
Cord blood or heelprick collection required.
Recent changes for Non Invasive Prenatal Analysis (NIPA)
ffDNA
BBREF, RCAG
Australian Red Cross Blood Service - Reference Red Cell Laboratory
Due to the samples short time limit:
Sample MUST be collected Monday to Wednesday only.
Samples MUST reach BHH Lab by 10am on those days.
Any samples collected outside of these times may be rejected and a recollection asked for.
Keep at Room Temperature
Must arrive in QLD within 36 hours on collection
Samples must arrive in QLD within 36 hours of collection.
Samples sent to: Australian Red Cross Lifeblood QLD
44 Musk Ave
Kelvin Grove QLD 4059
Samples to be packed as Ambient by an IATA certified person
Recent changes for Plasma Cell Flow Cytometry
Samples must be marked 'URGENT', must reach the laboratory as soon as possible.
All out-of-hours testing requires notification.
Time and date of collection must be recorded on request form.
Whole blood - 1 x EDTA sample, do not spin. Store at room temperature. An FBE and BLOOD FILM must also be requested, and needs a separate EDTA sample.
Bone marrow aspirate - Sample into EDTA tube
Tissue - Fresh (if to be shared with other departments for other tests eg. Histopathology or Microbiology) or RPMI fluid (especially if specimen is taken out of hours). This fluid is obtainable from: BH Lab 9895 3884, MH Lab: 9871 3572 or AH Lab: 9764 6136.
CSF/other fluids
Depending on the tests requested, 3-4 separate tubes will need to be provided. Note that the tubes are numbered so that order of collection can be identified – this order should be carefully followed, so that the optimal sample can be used for the requested tests. It is also important to consider the tests that are required, as this will determine how much CSF is needed in each tube. See the matrix below for details.
TUBE 1 is used for Biochemistry and Flow Cytometry. (Centrifuged in the lab – the supernatant is used for Biochemistry analysis (glucose, protein) and the cellular pellet will be used for flow cytometry if required). If tube 3 is bloodstained, take an aliquot for microbiology.
TUBE 2 is used for Cytology
TUBE 3 is for Microbiological analysis (cell count, Gram stain and culture) and any further infectious testing (e.g. viral PCR, mycobacterial PCR and culture, cryptococcal antigen).
TUBE 4 will be required only for;
(a) Creutzfeld-Jacob Disease (CJD) testing OR
(b) Xanthochromia analysis (wrap the tube in foil to prevent sample deterioration due to light).
TESTS REQUIRED
MINIMUM REQUIRED VOLUME (mL)
TUBE 1
TUBE 2
TUBE 3
TUBE 4
CHEMISTRY
1.0
ADD FLOW CYTOMETRY
Minimum 5.0-7.0
CYTOLOGY
 
1.0-3.0
MICROBIOLOGY
1.0-2.0
ADD OTHER INFECTIOUS MARKERS
add 2.0- 5.0-
ADD MYCOBACTERIAL CULTURE
Add 6.0-10.00
ADD CJD
ADD XANTHOCHROMIA
1.0 (foil)
Note, the ability to add further tests to a previously collected sample is dependent upon the volume provided. Also, many tests (flow cytometry, cytology) can only be performed on fresh specimens.
Recent changes for Plasma Cell Flow Cytometry Panel
Leucocyte Immunophenotyping
Plasma Cell Flow Cytometry Panel
LYMP, LEUK
Flow
EDTASterile Jar
EDTASterile JarCSF
Cut-off for outpatient sample collection on Fridays is at 11.30 AM and MUST reach the laboratory before 4.00PM.
Flow cytometric analysis of cells stained by immunofluorescence with a range of antibodies against lymphoid and myeloid markers.
Other specialised testing (e.g. oligoclonal bands) will be performed using the supplied samples.
Xanthochromia and CJD analysis cannot be performed on a blood-stained sample
Recent changes for Plasma Free Haemoglobin
Plasma Free Heamoglobin
Plasma Free Haemoglobin
Samples must be hand delivered to the lab to avoid shaking, which will falsely raise the plasma free-haemoglobin. Normal operating plasma free-haemoglobin level is < 0.10 g/dL. This is performed 24-hourly whilst on ECMO (routinely taken with the daily blood samples) according to clinical need/ECMO clinician direction.
Samples are taken by passively filling a 10mL syringe carefully from the intra-arterial line access port. Do not connect to a negative pressure “vacutainer” for sampling. The plasma free-haemoglobin collection tube is filled from the syringe after removing the lid, gently injecting blood from the syringe and then replacing the lid. No needles are required.
Lithium heparin no gel
Recent changes for PML:RARA, RUNX1,CBFB:MYH11 MRD/Screening
PML:RARA, RUNX1,CBFB:MYH11 Screening
PML:RARA, RUNX1,CBFB:MYH11 MRD/Screening
Samples to be kept at room temperature.
Do not spin.
Do not freeze.
Paediatric EDTA tubes cannot be used for these tests.
Recent changes for Polyomavirus PCR
Contact VIDRL 9342 2615
This test can be performed on same sample as other Micro PCR tests (eg CMV viral load). If unsure, contact Microbiology lab before organising any recollections.
Recent changes for Protein electrophoresis
Peter MacCallum Cancer Institute
Routinely, a qualitative, interpretive report of a capillary electrophoresis is made. It is important to provide adequate clinical information with the request for these interpretations to be meaningful.
comprehensive clincial notes are essential.
As of 14/06/2024 Serum Protein Electrophoresis performed by Sebia gel electrophoresis at Eastern Health.
Recent changes for Q Fever Serology
ICPMR (Institute of Clinical Pathology and Medical Research)
Contact VIDRL 9342 2649 / 9342 2650
Test performed by Institute of Clinical Pathology and Medical Research (ICPMR), NSW
Recent changes for Quantiferon TB-Gold
When packing for transport, the specimens MUST be packed in a separate transport esky at room temperature.
DO NOT put in an esky with cold packs.
QTFN, Quantiferon TB Gold
Quantiferon, TB Gold, QTFN
Recent changes for RAST
White top tube is the preferred sample.0.2ml of blood required for each allergen.
Blood collection: still can be done after skin allergy testing.
Omega-5-Gliadin, Alpha Gal and Cefaclor : serum send to Melbourne Pathology
IgG 96 Food Allergy test is not a RAST test It is performed at Australian Clinical Labs.This test is NOT rebatable and costs approx $260.
RAST for Omega-5-Gliadin to be sent to Alfred Pathology, Alpha Gal to be sent to Melbourne Pathology. Cefaclor and ARAh2 to be sent to Dorevitch Pathology
Omega-5-Gliadin: send to Melborne Pathology
Recent changes for Renin - plasma
Renin is stable in whole blood for up to 6 hours at room temperature.
In the laboratory, spin and separate the plasma. Plasma is stable at Room Temperature for up to 2 days.
Renin must be frozen at -70 C. if unable to test within 2 days.
Transport plasma at room temperature.
Add-on tests for Renin and Aldosterone should not be done on samples which have been previously collected or stored at 4 C.
Renin must be frozen at -70 C. if unable to test within 2 days at the Box Hill Laboratory.
In the laboratory, spin and separate the plasma immediately. Plasma is stable at Room Temperature if analysis is performed on the same day.
Renin must be frozen at -80 C. Transport plasma at room temperature (Maroondah and Angliss) until it can be placed in -80 C Freezer.(Must be done within 3-4 hours).
Renin will not be collected at Healesville Hospital and Yarra Ranges Health Collection Rooms.
Samples from Angliss and Maroondah must be collected within business hours to allow transport to Box Hill via courier.
Spin,seperate and freeze (-80 C), transport frozen.
Minimum plasma volume: 500 ul (1mL if aldosterone is also requested)
Prior to testing, patients should be withdrawn from diuretics, ACE inhibitors, angiotensin II receptor antagonists, beta blockers and calcium channel blockers for 3 weeks. Patients should also be well hydrated, have had 7g/day of salt for one week and have normal plasma potassium and bicarbonate levels.
Deliver to laboratory ASAP at room temperature
Deliver to laboratory at room temperature
Renin must be frozen at -80 C. Transport plasma at room temperature (Maroondah and Angliss) until it can be placed in -80 C Freezer.(Must be done within 3-4 hors).
Recent changes for Rickettsia spp. Screen Serology
Tests for Total Ab, IgM response to Spotted fever, Typhus and Scrub Typhus groups.
Tests for serology response to Spotted fever, Typhus and Scrub Typhus groups.
Recent changes for Ristocetin Co-Factor assay
Fortnightly
Recent changes for Short Synacthen Test
Every synacthen test must have cortisol measured on all 3 serum tubes.
See ACTH instructions for processing of EDTA sample. (collect onto Ice and send immediately to the laboratory)
If the synacthen test is for " Congenital Adrenal Hypoplasia"/"CAH", Each serum sample must also have 17-hydroxyprogesterone (in addition to cortisol ) measured.
Endocrine consultation is suggested for Long synacthen Test.
The Short Synacthen Test may be requested in the investigation of patients for "Addison's disease", "Adrenal failure" or Congenital Adrenal Hypoplasia" (CAH).
The test involves IM/IV administration of 250 micrograms of synacthen (synthetic ACTH) by an appropriate clinician.
Laboratory staff: the first Cortisol specimen should be booked in as 'SYN' this is the test code for the synacthen stimulation test. Subsequent samples collected at 30 and 60 mins should be booked in as CORTX
Laboratory staff: Specimens should be booked in as 'SYN' this will trigger registration for CORT0, CORT30 and CORT60. If an EDTA is also recieved this can be registered for ACTH as well. DO NOT use CORTX.
Recent changes for Soluscopes for sterility testing
Soluscope should be sent to laboratory in sterile container
Culture
not required
Not required
Sterile Jar
Recent changes for STI - Sexually Transmitted Infection Microscopy & Culture
Gel, charcoal, and VTM (COVID) swabs are NOT suitable for STI PCR. You MUST use the white top STI PCR swab.
Use the orange charcoal swab for urethral swabs for Gonorrhoea culture. A gel swab can be used for other genital sites (eg HVS).
Microbiology Collection Guide
https://pathology.easternhealth.org.au/handbook/downloads/microbiology/Microbiology_Specimen_Collection_Guide.doc
Note: swabs are required for culture and PCR; urine samples are suitable for PCR testing only.
https://pathology.easternhealth.org.au/handbook/downloads/microbiology/WORK-MI-89%20Microbiology%20Swab%20Specimen%20Collection.docx
Sexually Transmitted Infection Microscopy & Culture
STI - Sexually Transmitted Infection Microscopy & Culture
Recent changes for Stratify JCV
Samples are be aliquoted and frozen in the barcoded tube supplied in the JCV kit
Recent changes for Thiopurine Methyl Transferase Genotyping
Thiopurin Methyl Transferase Genotyping
Thiopurine Methyl Transferase Genotyping
TPMT activity replaced by genotyping
TPMT, TPMTG, TPMT genotyping, TPMT genotype
Australian Clinical Labs (formerly Healthscope)
Melbourne Pathology
Recent changes for Tryptase
Mast Cell - Tryptase
Tryptase
Mast Cell Tryptase
0.5 mL
Stable 48 hours refrigerated, transport frozen if unable to ensure delivery of sample to the Alfred within 48 hours of collection. .
Separate serum and store frozen - 20 degrees.
Spin, separate and freeze serum if unable to ensure delivery of sample to the Alfred within 48 hours of collection. .
Spin, separate and freeze serum
Recent changes for Urine Aldosterone and Sodium - 24 hour (Oral salt loading test)
Aldosterone - urine
Urine Aldosterone and Sodium - 24 hour
24-hour urine collection in acid bottle
Keep refrigerated during collection and send to laboratory immediately on completion
24-hour urine collection in acid bottle. Aldosterone and Sodium must be tested from the same ACID bottle.
DO NOT issue a separate24-hour plain bottle for urine sodium.
If unsure, confirm with the lab before advising recollection.
24-hour aldosterone, 24 hour urine aldo
Aldosterone excretion is physiologically inversley related to sodium status and must be interpreted in relation to sodium secretion.
Aldosterone excretion is physiologically inversley related to sodium status and must be interpreted in relation to sodium excretion. Sodium and Aldosterone assay performed on same collection by referral lab.
Recent changes for Urine Catecholamines
If requested on a Paediatric patient, please seek Chemical Pathologists approval.
Record request as Urine Metnaphrines, follow instructions as per urine metanphrines, and add to Chemical Pathologist Review List.
24 hour urine, in acid bottle, a 50 ml aliquot is referred out along with the recorded total 24 hrs volume and pH level.
Extra 50 mL aliquot need to be stored.
Paediatric patients - See Chemical Pathologists for approval
Recent changes for Urine Protein Electrophoresis
Samples less that 20 mL are insufficient and should be rejected.
Samples less that 5 mL are insufficient and will be rejected.
Recent changes for Vancomycin
As of 04/02/2025 assay no longer performed at Angliss Laboratory. Samples are to be sent to Maroondah Laboratory via internal courier. If specifically marked Urgent outside routine courier hours send via taxi.
Request must specify: dose, route, time(s) of dose/infusion and collection time.
For intermittent dosing, a Pre-dose sample is required
Post-dose levels are seldom indicated as levels do not correlate with toxicity or efficacy.
Recent changes for von Willebrand Screen
Haematology
Recent changes for vWF Activty
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