Pathology @ Heartlands, Good Hope and Solihull Hospitals

For a list of our accredited tests please visit the UKAS Website HEFT or UKAS PHE

The pathology department at Heartlands Hospital is part of University Hospitals Birmingham and serves Heartlands, Good Hope and Solihull Hospitals and in addition to providing services for GPs in and around Birmingham and Solihull

Directorate News

  • DOAC STOP

    Direct Oral Anticoagulants (DOACs) are a relatively new class of anticoagulants that have several advantages over traditional anticoagulation agents such as Warfarin. This includes rapid onset of action, few drug interactions and predictable pharmacokinetics which result in no requirement for routine laboratory monitoring. As a result, the use of DOAC’s in clinical practice has grown. The DOAC’s are problematic for the laboratory as they have been reported to interfere with most coagulation tests to varying degrees.

    Currently when testing a patient for a thrombophilia a patient is required to be free from anticoagulation to obtain a valid result, however due to the risk of thrombosis these patients are also required to be anticoagulated. This paradox is problematic for both the laboratory and the clinician.

    DOAC-Stop tablets can be used to efficiently remove all types of DOACs including dabigatran, apixaban, rivaroxaban and edoxaban, from test plasmas with minimal effect on plasma proteins involved in the clotting mechanism. This will allow clinicians to get an accurate result while the patient is anticoagulated with a DOAC, preventing the need for cessation for an accurate result and therefore reducing the risk of thrombosis.

    If you are requesting a thrombophilia or lupus anticoagulant screen and your patient is on a DOAC, please state clearly on the request form, together with which anticoagulant, so DOAC Stop can be applied.

     

    Read more

  • Corona Virus Update

    Corona Virus Update

    Due to the current demand on all Pathology services in relation to the Corona virus and the impact on processing samples some non-urgent tests may see a delayed turnaround time. Please be assured that this wil not impact on urgent requests.

    Read more

  • Changes to Biochemistry Phone Limits

    From Monday 17th June the Biochemistry phone limits at Heartlands/Good Hope and Solihull will change (see table below).  The new limits are already in place on the Queen Elizabeth site and so we will now be phoning the same results across all sites.   The new limits reflect changes to the Royal College of Pathologists guidance.

    Analyte

    Phone results below or equal to:

    Phone results above or equal to:

    Units

    Notes

    Sodium

    120

    150

    mmol/L

     

    Potassium

    2.5

    6.5

    mmol/L

     

    Urea

    -

    30

    mmol/L

     

    Creatinine

    -

    Paediatrics: >354

    umol/L

    Except those on renal wards or under renal consultants.

    eGFR

    Adults: <15

    -

    ml/min

    AKI

    -

    2

     

    Not CKD patients

    Glucose

    2.5

    25

    mmol/L

     

    Calcium adjusted

    1.8

    3.5

    mmol/L

     

    Magnesium

    0.4

    -

    mmol/L

     

    Phosphate

    0.3

    -

    mmol/L

     

    AST

    -

    600

    U/L

     

    ALT

    -

    600

    U/L

     

    Total CK

    -

    5000

    U/L

     

    Amylase

    -

    500

    U/L

     

    Digoxin

    -

    2.5

    ng/mL

     

    Theophylline

    -

    25

    mg/L

     

    Phenytoin

    -

    25

    mg/L

     

    Lithium

    -

    >1.5

    mmol/L

     

    Troponin T

    -

    GP only: >14

    ng/L

    GP only

    Ammonia

    -

    100

    umol/L

     

    Ethanol

    -

    Paediatrics only: any detectable

    mg/L

    Paediatrics only

    Paracetamol

    -

    10

    mg/L

    Not ED patients

    Salicylate

    -

    300

    mg/L

    Not ED patients

    Conj bilirubin (DBIL)

    -

    Paediatrics only:

    25

    umol/L

    Paediatrics only

    Total bilirubin

    -

    Paediatrics only: 225

    umol/L

    Paediatrics only

    Carbamazepine

    -

    25

    ug /mL

     

    Iron

    -

    ED only: 70

    umol/L

    ED only

    Phenobarbitone

    -

    70

    mg/L

     

    CSF Gluc

    -

    5.0

    mmol/L

     

    CSF Prot

    -

    0.45

    g/L

     

    Lactate

    -

    2.3

       

    CRP

    -

    300

       

    Total bile acids

    -

    20

       

    Methotrexate

    Phone all

    umol/L

     

    Read more

  • CLL - Residual Disease Update

    CLL - Residual Disease Update

    Website update for CLL MRD

    Minimal residual disease for CLL is performed by flow cytometry within the Cell Markers Lab in Haematology. The procedure for measurement has been reviewed and updated in line with current recommendations1. The new panel provides clearer delineation of CLL populations and is able to exclude other minor B cell populations such as haematogones and plasma cells.

    Sample requirements remain the same: either 1-2mls of Bone marrow or 4-5 mls PB in EDTA (although additional sample may be advisable in patients who are leucopenic).

    Samples should be received and tested within 48 hours to ensure meaningful results (note that the laboratory is not open at weekends).

    Reporting of CLL MRD has also been updated to provide additional information and will include:

    A summary statement

    A quantitation (%)                       ONLY if the level is at or above the limit of quantitation

    Limit of detection (LOD)         The percentage above which CLL cells can be recognised but there are                                                                        too few to be reliably quantified.

    Limit of quantitation (LOQ)    The minimum percentage at which CLL cells may be quantified.

    LOD and LOQ are calculated for each patient sample.

    The procedure has been optimised to achieve an LOD of 0.004% and an LOQ of 0.01%, but this is dependent upon the cellularity of the sample and may therefore be higher (and thus less sensitive).

    1A complementary role of multiparameter flow cytometry and high-throughput sequencing for minimal residual disease detection in chronic lymphocytic leukaemia: a European Research Initiative on CLL study.

    Rawstron et al

    Leukaemia2016 Apr;30(4):929-36. doi: 10.1038/leu.2015.313. Epub 2015 Dec 7

    Read more

  • BD Vacutainer Tube Guide

    BD Vacutainer Tube Guide

    The BD Vacutainer tube guide detailing order of draw and special instruction can be downloaded from the Downloads tab or by clicking here

    Read more

  • Notification of Change: upgrade of instrumentation For Virology Real-Time PCR testing

    In order to improve the service to our users we have upgraded the instrumentation used to perform the testing and detection of Viral and Bacterial nucleic acids by real time PCR. A full validation of the change has been performed and users will be informed of any change in performance characteristics.
    However, these assays now lie outside our scope of accreditation as assessed by UKAS. UKAS have been informed and will assess the assays on the new instrumentation as an extension to scope of our accreditation at our next inspection. This is normal procedure when changing platforms.

    Read more

Copyright heftpathology 2013, 2014, 2015, 2016, 2017, 2018

HTA licence number is 12366

Protection of Personal Information – Laboratory Medicine comply with the Trust Data Protection Policy and have procedures in place to allow the Directorate and it’s employees to comply with the Data Protection Act 1998 and associated best practice and guidance.

The Trust Laboratories at Heartlands Hospital, Good Hope Hospital and Solihull Hospital were awarded UKAS (United Kingdom Accreditation Service) accreditation to the internationally recognised ISO 15189 standard in May 2015. For a list of accredited tests and other information please visit the test database http://www.heftpathology.com/frontpage/test-database.html.
Tests not appearing on this scope are either under consideration or in the process of accreditation and so currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.

For further information contact Louise Fallon, Quality Manager, 0121 424 1235

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