Transplant Pancreas Biopsy Kit Instructions

Step 1:  Complete the Transplant Pancreas Biopsy Requisition Form

  • A completed Requisition Form must accompany all requests. It should contain: patient name, ID number, date of biopsy, tissue source, biopsy site, clinical history, lab data (e.g. glycemia, serum amylase and lipase), and questions to be answered with diagnosis if known. The History Form may be used to submit this information. Include other pertinent history and findings, such as radiographic findings, cancer history or treatment history.
  • Please clearly and accurately indicate on the requisition form the name and phone number of the physician to be called by our pathologists with the preliminary results. Failure to do so may delay the reporting of the biopsy results.
  • REQUIRED:  FAX requisition form, billing information and history form prior to shipping to (319) 384-7213.

Step 2:  Specimen Preparation

  • All containers must be labeled with patient name, identification number, and tissue source.
  • Specimens may be obtained by percutaneous needle (core) or laparoscopic biopsy. In patients with bladder drainage, cystoscopic transduodenal pancreas biopsies may be obtained.
  • It is recommended that pancreas graft biopsies contain at least 3 lobular areas and their associated interlobular septa. If possible, having a touch imprint performed, with intra procedural adequacy evaluation by a pathologist can be performed (optional), with care and attention to that fibrotic pancreas biopsies may lead to false negative results. If this is not possible, using a dissecting or light microscope is useful to differentiate the pancreatic parenchyma from fibrous tissue or fat.
  • If intra procedural evaluation by a pathologist is not possible, usually an 18 gauge needle core biopsy yields satisfactory amounts of tissue.

CORES OF TISSUE:

Light Microscopy (LM) Specimen:

  1. Place the core(s) in the vial of 10% buffered formalin.
  2. Label with patient name, unique patient ID # or date of birth and collection date.

C4d Testing on the Weekend:

  1. It the biopsy is on Friday and the specimen is a STAT to be read on Saturday with the need for C4d on Saturday, then a small portion of tissue should also be sent in Michel’s media for C4d immunofluorescence. 

If difficulties are encountered, contact the local transplant surgeon or call Danniele Holanda, MD, (dial (319) 353-6212, pager #3925).

Step 3:  Specimen Packaging and Shipping

Fed Ex packaging guidelines for UN3373 shipments apply to the transport of a pancreas biopsy to the UIDL.  Anyone shipping a pancreas biopsy should be aware of all applicable guidelines and regulations. Senders are solely responsible for compliance.  See www.fedex.com and SEARCH 3373 for details. 

  • Place all vials in specimen transport bag with absorbent pad.
  • Include all completed paperwork with specimens.
  • Place sealed bag in the transport box.
  • Place the closed transport box inside the FedEx ClinPak and seal.
  • Affix a fully completed FedEx Airbill marked for FIRST OVERNIGHT DELIVERY on the outside of the Fed Ex ClinPak.  Affix "FO" label on the outside of FedEx ClinPak.
  • Complimentary FIRST OVERNIGHT shipping via Fed Ex should ensure receipt in the UIDL by 8 am CST M-F and same day results.  Specimens are also received on the weekend with STAT services available.

NOTE:  SATURDAY DELIVERIES
Be sure to mark airbill for Saturday Delivery and Priority Overnight to ensure proper delivery.  Affix “SDR” label on the outside of FedEx ClinPak.  Saturday deliveries (STAT biopsies) not properly marked will NOT arrive on Saturday and will processed on Monday upon arrival.

Ship at ambient temperature.  DO NOT FREEZE.

SHIP BIOPSY TO:
UI Diagnostic Laboratories (UIDL)
200 Hawkins Drive 5231 RCP
Iowa City, IA 52242-1087

Client Services:  1-866-844-2522
FAX:  1-319-384-7213

BIOPSY RESULTS:  The pathologist will call the preliminary diagnosis to the referring transplant surgeons the same day the biopsy is received (Monday – Friday).  Same-day results for STAT biopsies are available on weekends and holidays upon request by the client.  Final reports will be faxed and copies will be mailed to the client.