CAGT- PRE-TRANSPLANT WORKUP		version 5/9/2024		

Provider Communication 	

	
	Interval	Defer Until	Duration	
	☐	Please place procedure, imaging, and referral orders using your preference list. These orders must be placed outside of the therapy plan to be scheduled.	Once	S	1 treatment	
		Place Donor Center, In clinic procedure, Pulmonary, Cardiology, Imaging, and Referral orders outside the plan. This is required for scheduling purposes. 		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	BMT Nursing Communication	Once	S	1 treatment	
		Schedule BMT Education Class		
	☐	Nursing communication	Once	S	1 treatment	
		Allogeneic: 2 pink tops to Dr Leveque for pheno typing		
	☐	Nursing communication	Once	S	1 treatment	
		Other		
	☐	Formalize NMDP Donor Search	Once	S	1 treatment	
		No details available for preview		
	☐	Infectious Disease Markers- Performed by NMDP Lab	Once	S	1 treatment	
		No details available for preview		
	☐	NMDP Communication- Invoice/Charges	Once	S	1 treatment	
		No details available for preview		
	☐	CAGT Discussion/Results	Once	S	1 treatment	
		No details available for preview		

Labs- Donor Panel  	

	
	Interval	Defer Until	Duration	
	☐	CBC with platelet and differential	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Prothrombin time with INR	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Partial thromboplastin time, activated	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Comprehensive metabolic panel	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Protein, total	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	LDH	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Uric acid level	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Phosphorus level	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Magnesium level	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Urinalysis screen and microscopy, with reflex to culture	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE
	Specimen Source: Urine
	Specimen Site: Clean catch		
	☐	Gulf Coast serology test	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Type and screen	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	HLA specimen	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Draw 2- ACD yellow top tubes for HLA Typing (low or high resolution) OR STR's (chimerism).  NOTE the desired test here AND submit the HLA requisition with the sample.
	
	Test Type:   {:11558517}		
	☐	HLA antibody testing - pre transplant	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	B natriuretic peptide	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		

Labs 	

	
	Interval	Defer Until	Duration	
	☐	Cytomegalovirus Ab, IgG	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Cytomegalovirus Ab, IgM	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Sickle cell screen	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	hCG quantitative, serum	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Immunoglobulin G	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Immunoglobulin A	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Immunoglobulin M	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Prostate specific antigen	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE
	Release to patient (Note: If manual release option is selected, result will auto release 5 days from finalization.): Immediate		
	☐	Toxoplasma IgM Ab	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Toxoplasma gondii antibody, IgG	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Epstein-Barr virus antibody panel	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Strongyloides Ab IgG ELISA	Once	S	1 treatment	
		Routine, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		

Labs- Disease Specific 	

	
	Interval	Defer Until	Duration	
	☐	Beta-2 microglobulin	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Serum electrophoresis	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE
	Includes immunofixation		
	☐	Kappa lambda free light chain with ratio	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Protein, urine, 24 hour	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Creatinine level, urine, 24 hour	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Urine protein electrophoresis, 24 hour	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE
	Includes immunofixation		
	☐	Creatine kinase, total (CPK)	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		

Labs - AML Patients Only: Iron Studies 	

	
	Interval	Defer Until	Duration	
	☐	Iron level	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Ferritin level	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		
	☐	Total iron binding capacity	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, HMH DEPARTMENT OF PATHOLOGY AND GENOMIC MEDICINE		

Procedures 	

	
	Interval	Defer Until	Duration	
	☐	CAGT Venous Access Evaluation Order	Once	S	1 treatment	
		Clinic Performed, Normal
	Performing Department: Blood Donor Center		
	☐	Bone marrow biopsy w/ sedation	Once	S	1 treatment	
		Clinic Performed, Normal
	Performing Department: Blood Donor Center		
	☐	Bone marrow biopsy w/out sedation	Once	S	1 treatment	
		Clinic Performed, Normal
	Performing Department: Blood Donor Center		

Imaging 	

	
	Interval	Defer Until	Duration	
	☐	ECG 12 lead	Once	S	1 treatment	
		Ancillary Performed, Normal		
	☐	XR Chest 2 Vw	Once	S	1 treatment	
		Normal, Routine, Ancillary Performed
	PA and Lateral		

Referrals 	

	
	Interval	Defer Until	Duration	
	☐	Referral to Oncology Social Worker	Once	S	1 treatment	
		Internal Referral