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Requisition, Sample Collection, and Shipping
ADHESION
This package includes information for the requisition of research assay tests performed by the
Red Blood Cell Laboratory.
For questions, please contact:
Sandra Larkin
Phone: (510) 450-7621
Fax: (510) 450-7910
Email: RBC lab@chori.org
Page 2: Requisition form
Please complete the requisition form and include it with samples shipped appropriately (see page 3). Visit
www.rbclab.com for detailed information on the tests provided.
Page 3: Sample collection, processing, and shipping
Please carefully read the sample collection and shipping instructions on page 3, and label the collection
tubes clearly. Indicated in the table below are the tests of the analytes in different media.
For tests on plasma or serum, blood can be separated locally, labeled, and stored at -80°C until enough samples
are collected to make shipping on dry ice economical. Similarly, urine can be shipped in batches. Please contact
us to discus such details.
Adhesion Factors (FX6): includes sICAM-1,
sICAM-3, sPECAM, sVCAM-1, sE-selectin,
and sP-selectin
Leukocyte-selectin (Lsel)
Endothelial-selectin (Esel)
Platelet-selectin (Psel)
Soluble intracellular adhesion molecule-1
(sICAM-1)
Soluble intracellular adhesion molecule-3
(sICMA-3)
Soluble vascular cell adhesion molecule-1
(sVCAM)
Serum
Plasma
citrate
Plasma
EDTA
Plasma
heparin
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
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RBC LAB REQUISITION FORM
ADHESION
This form must accompany each sample set and
must be completed fully in order for samples to be processed!
Study Name and Number: _____________________________________________
Attach a hard copy of the list of samples to this form (including all of the information on
the tube labels): Sample Name, sample ID#, date drawn, assay. Send excel file by email.
Check all that apply:  FX6  Lsel  Esel  Psel
 sICAM-1  sICAM-3  sVCAM
Name of Requesting Institution: _______________________________________
____________________________________________________
Address:
____________________________________________________
____________________________________________________
____________________________________________________
Physician or Prinicpal Investigator:_____________________________________
Phone#: __________________________Fax#: _____________________________
Email: _____________________________________________________________
Study Coordinator: __________________________________________________
Phone#: __________________________Fax#: _____________________________
Email: _____________________________________________________________
RBC lab use only
Date/Time received: _________________________________
Date/Time processed: ________________________________
 Inappropriate storage, delivery, or containment
Explain:____________________________________
 Requisition form incomplete
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Sample Collection Requirements - ADHESION
Serum
Adhesion Factors (FX6)
Leukocyte-selectin (Lsel)
Endothelial-selectin (Esel)
Platelet-selectin (Psel)
sICAM-1
sICMA-3
sVCAM-1
X
X
X
X
X
X
X
Plasma
citrate
X
Plasma
EDTA
X
X
X
X
X
X
X
X
Plasma
heparin
X
X
X
X
X
X
Serum:
Collection / Container / Volume: Collect a 2-5 ml blood sample by routine venipuncture into a
serum separator tube (red top or tiger top tubes). Store 0.5 ml serum aliquots in 1 ml cryovials.
Labeling: please include a sample ID# and date/time drawn on each vial.
Processing: After allowing sample to clot for 30 minutes, centrifuge for 5 minutes at 1000 x g.
Remove serum and store at 2-8oC for assay within 24 hours or aliquot and store samples frozen
(preferably at -80oC, then the stability is at least 1 year). Grossly hemolyzed samples are not suitable
for measurement.
Plasma:
Collection / Container / Volume: Collect a 2-5 ml blood sample by routine venipuncture into a
vacutainer containing one of the following anticoagulants: EDTA, heparin, or citrate (as appropriate
for specific assay requested, see table above). Store 0.5 ml plasma aliquots in 1 ml cryovials.
Labeling: please include a sample ID# and date/time drawn on each vial.
Processing: Specimen must be centrifuged for 5 minutes at 1000 x g within 30 minutes of collection.
Remove plasma and store at 2-8oC for assay within 24 hours or aliquot and store samples frozen
(preferably at -80oC, then the stability is at least 1 year). Grossly hemolyzed samples are not suitable
for measurement. Avoid repeated freeze/thaw cycles.
Transport: Ship batches on dry ice by overnight shipping.
Shipping:
Sandra Larkin, RBC Lab, Room 1114
Children’s Hospital Oakland Research Institute
5700 Martin Luther King Jr. Way
Oakland, CA 94609
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