Blood Transfusion


Cold haemagglutinin disease (CHAD) accounts for 16-32% of all cases of immune haemolysis. It occurs as an acute or chronic condition. The acute form is often secondary to lymphoproliferative disorders or Mycoplasma pneumoniae infection.


  • Samples for this test must be maintained at 37oC from the time collected and during transport to the laboratory
  • An insulated box is available from the Immunology Department at GRH or Pathology Reception CGH
  • Samples which have NOT been kept at 37oC are unsuitable for testing
  • If a gold top serum gel tube is sent without an EDTA sample, the test cannot be performed
  • The test is performed at CGH and GRH
  • This is a non-accredited test as there is no EQA scheme available
  • The following factors are known to significantly affect the performance of the examination or the interpretation of the results: lipaemia, sample clotted (if EDTA), haemolysed. Any sample displaying these factors cannot be processed and will be rejected

Sample Requirements

Plain clotted (red topped) sample OR

EDTA sample AND SST clotted sample kept at 37oC.

A plain clotted sample (red top) OR a purple-top EDTA AND an SST sample from the patient once collected from the patient must be maintained at 37oC from the point of collection until receipt in the laboratory.

Serum tube - 6mL

Gold top with cap


6mL EDTA tube

EDTA with cap


Red TOP 6mL Serum

6ml red top tube

Required Information

Sample and request form must be labelled correctly with 4 points of reference:

  1. Unique identification number
  2. Surname
  3. First name
  4. Date of birth.

Unlabelled, incorrectly labelled or inadequately labelled specimens will not be accepted. No specimen is considered unrepeatable

The sample must be labelled, signed and dated by the person taking the blood

Alert values

If titre > 1/64 at 4oC and reacting at 37oC in adult O cell, cord O cell or auto, then the test is positive.

Turnaround times

Within 48 hours


Author: Stuart Lord, Transfusion Practitioner

Reviewed date: 14/03/2023

Next review date: 14/03/2025