Test Code CHIMU Chimerism Transplant No Cell Sort, Varies

Reporting Name

Chimerism Transplant No Cell Sort

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Determining the relative amounts of donor and recipient cells in a specimen

An indicator of bone marrow transplant success

Method Name

Polymerase Chain Reaction (PCR) Amplification/Capillary Electrophoresis

Ordering Guidance

This test is for the post-bone marrow transplant evaluation of the presence of donor cells in the post-transplant recipient specimen. For post-bone marrow transplant testing to determine the relative amounts of donor and recipient cells, see CHIMS / Chimerism Transplant Sorted Cells, Varies

Additional Testing Requirements

Shipping Instructions

1. Specimen must arrive within 7 days of collection.

2. Collect and package specimen as close to shipping time as possible.

Necessary Information

Specimen Type is required, either as an answer to the Order Questions or on Chimerism Analysis Information (T594) if not ordering electronically. Testing will be delayed if this information is not provided.

Specimen Required

Submit only 1 of the following specimens:

Specimen Type: Blood

Container/Tube:

Preferred: Lavender top (EDTA)

Acceptable: Yellow top (ACD)

Specimen Volume: 4 mL

Collection Instructions:

1. Only 1 tube is required.

2. Invert several times to mix blood.

3. Label specimen as blood.

4. Send whole blood specimen in original tube. Do not aliquot.

Specimen Type: Bone marrow

Container/Tube:

Preferred: Lavender top (EDTA)

Acceptable: Yellow top (ACD)

Specimen Volume: 2 mL

Collection Instructions:

1. Invert several times to mix bone marrow.

2. Label specimen as bone marrow.

3. Send bone marrow specimen in original tube. Do not aliquot.

Specimen Type

Varies

Specimen Minimum Volume

Blood: 3 mL
Bone marrow: See Specimen Required
Lesser volumes may be acceptable, depending on white cell count.
Call 800-533-1710 or 507-266-5700 with questions.

Specimen Stability Information

Specimen Type	Temperature	Time	Special Container
Varies	Ambient (preferred)	7 days	PURPLE OR PINK TOP/EDTA
	Refrigerated	7 days	PURPLE OR PINK TOP/EDTA

Reject Due To

Gross hemolysis	Reject
Moderately to severely clotted	Reject

Reference Values

An interpretive report will be provided.

Interpretation

An interpretive report will be provided, which defines unique features of the donor's cells.

It is most useful to observe a trend in chimerism levels. Clinically critical results should be confirmed with 1 or more subsequent specimens.

Day(s) Performed

Monday through Friday

Report Available

4 to 8 days following receipt of Pre and Donor Specimens

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

81267-Chimerism (engraftment) analysis, post hematopoietic stem cell transplantation specimen, includes comparison to previously performed baseline analyses, without cell selection

LOINC Code Information

Test ID	Test Order Name	Order LOINC Value
CHIMU	Chimerism Transplant No Cell Sort	34574-4

Result ID	Test Result Name	Result LOINC Value
MP026	Specimen Type	31208-2
37313	Final Diagnosis	34574-4

Forms

1. Chimerism Analysis Information Sheet (T594)

2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.

Testing Algorithm

Complete chimerism analysis requires 3 specimens, under 3 separate orders, for the 3 separate tests listed below. These specimens should be submitted when collected. An interpretive report will be provided once all specimens are received.

Pre-Transplant:

-CHRGB / Chimerism-Recipient Germline (Pretransplant), Varies

-CHIDB / Chimerism-Donor, Varies

-ADONO / Additional Chimerism Donor (Bill Only), if applicable

Post-Transplant:

-CHIMU / Chimerism Transplant No Cell Sort, Varies or CHIMS / Chimerism Transplant Sorted Cells, Varies

Billing occurs with the following tests:

Pre-transplant: