Medical advances in blood donor screening and testing have dramatically improved blood safety. Additionally, changes in technology have imposed enormous demands on blood donor centers. The American Red Cross' National Testing Laboratories (NTLs) are designed as high throughput streamlined laboratories to efficiently process and test donor samples and to release reliable results in a timely manner.

The following tests are performed on each unit of donated blood:

• ABO/Rh determination
• Antibody screening for unexpected red cell antibodies
• Antibodies to Treponema pallidum for Syphilis*
• Antibodies to Human Immunodeficiency Virus (anti HIV 1/2)*
• Hepatitis B surface antigen (HBsAg)*
• Antibodies to Hepatitis B Core Antigen (anti-HBc)*
• Antibodies to Hepatitis C Virus (anti-HCV)*
• Antibodies to Human T-Cell Lymphotropic Virus (anti HTLV I/II)*
• Antibodies to CMV (Cytomegalovirus) - selected specimens only
• Nucleic Acid Testing for HIV-1/HCV and West Nile Virus (WNV)*

*Confirmatory/supplemental testing is performed on reactive samples by a variety of methods.

Five American Red Cross NTLs are located as follows:

Charlotte NTL*
13500-A South Point Blvd
Charlotte, NC 28373

Portland NTL
12124 NE Ainsworth Circle
Portland, OR 97220

Detroit NTL
100 Eliot Street
Detroit, MI 48201

St. Louis NTL
4050 Lindell Blvd
St. Louis, MO 63108

Philadelphia NTL
700 Spring Garden Street
Philadelphia, PA 19123

*Includes the Confirmatory Laboratory that performs serologic and virologic testing on reactive blood donation samples.

All blood collected by the American Red Cross regional blood centers is tested by the NTLs. This modern system of fewer and larger standardized laboratories allows a systematic approach to changes in technology, new test implementations and are able to respond to medical and scientific challenges. Additionally, the American Red Cross NTLs provide services to non-Red Cross blood centers and hospitals.

• Fewer, Larger Laboratories
  The first of the National Testing Laboratories was opened in August, 1992, and the final NTL was opened in May 1995. Today, all of the nearly 7.2 million units of blood donated annually to the American Red Cross are tested at the organization's NTLs in Detroit, MI; Philadelphia, PA; Charlotte, NC; Portland, OR and, St. Louis, MO.
• Identical Operating Procedures, Training and Equipment
  Implementation of standardized operating procedures and training, and identical equipment at all NTLs improve quality control and facilitate the adoption of new technology. Each NTL maintains a quality assurance program to help ensure high testing standards.
• Quality Service Delivery and Economies of Scale
  Ninety-five percent of all blood is tested by the NTLs within 15 hours from the time the blood samples are received from the regional blood centers; 99 percent of all blood is tested within 24-hours. The requisite technology and automation enable the American Red Cross to meet high-service requirements at lower costs.
• Collaborators in Blood Safety and Research
  The NTLs-because of their size and identical equipment and procedures-also collaborate with American Red Cross scientists and other investigators to qualify new test systems, and to participate in other research studies, to improve blood donation testing efficiency and blood component safety.
• Tests from 7.2 Million Samples Each Year
  Standardized operating procedures, equipment and training maximize sample testing flow and flexibility.
• Emergency Back-up Plan
  Each NTL can transfer its testing to other NTLs for emergency purposes in case of natural disasters or unanticipated events, and each was designed with the capacity to accommodate just such occurrences.
• Testing Support
  Testing Support, located in Charlotte, NC, provides Quality Assurance, Human Resources, Process Optimization and Operations Support for the five NTLs.