Latest News

  • Changes in Renin and Aldosterone Service

    Item Author Joanne Duffy

    Due to difficulties in obtaining sufficient kit supplies for our Renin workload, it is with regret that we will no longer be able to offer the measurement of Renin, and subsequently Aldosterone , from this laboratory.

    We have been working closely with our colleagues at University Hospital Birmingham (UHB) and will be sending work there from the 28/2/2018. The Renin assay provided by UHB is an Immunoassay method (IDS iSYS) for renin mass with reference ranges comparable to the ones used at Heartlands.  See attached information.  The aldosterone method is a comparable assay by LC/MSMS.

    The UHB laboratory is a UKAS accredited laboratory.  The aldosterone assay is already UKAS accredited and the Renin immunoassay will be assessed by UKAS as part of their next extension to scope application.

    The aldosterone assay is in essence identical to the one used at Heartlands. It is a mass spec method and should have the same characteristics. The information should be applicable.

    There will be a slight change in the ratio cut offs used to take into account the renin method. We will be using the Endocrine guidelines ranges and use the 91 cut off with and Aldosterone greater than 750 as a “screen” positive interpretation. This is taken from the Endocrine guidelines on the investigation of Conns.

    From a sample processing point of view continue to send the samples to Heartlands and we will  transport the samples to UHB.

    Please contact the lab or duty biochemist if you have any queries

  • Notification of Change: Revision to PNH screen by Flow Cytometry

    Item Author Mark Hill

    Revision to PNH screen by flow cytometry

    From the 26th February the current PNH screen will be updated.

    The revised protocol will include analysis of monocytes in addition to neutrophils and red cells. Monocyte analysis provides additional evidence for PNH, and in some cases gives a truer reflection of PNH clone size.

    The sensitivity of the assay has been determined and the lower limit of quantitation is 0.01% for both red cell and neutrophil analysis. To achieve this level of sensitivity we need to count a large number of cells.

    In cases of neutropenia it can be difficult to acquire sufficient cells for the desired sensitivity. We therefore recommend that freshly taken, full EDTA tubes are sent. It may still not be possible to provide a result in severely neutropenic cases.

    Monocyte analysis is less sensitive to small populations due to the lower number of monocytes available in samples.

    Red cell analysis is performed to allow recognition of PNH type II and PNH type III clones and should not be used as a definitive measure of clone size. Please supply details of transfusion history.

    It is possible to recognise tiny rbc and neutrophil clones at <0.01%, but these are not quantifiable.

    The format of reports will be updated to reflect the changes and provide greater clarity of the results.

    This will be reviewed during our October UKAS inspection.

    Please contact the Haematology Cell Markers laboratory on 0121 424 0704 if you require further information.

  • Change in Glandular Fever screen

    Item Author Mark Hill

    The current UKAS accredited Glandular Fever screen offered by HEFT laboratories has been discontinued by Alpha Laboratories (the supplier). We are currently in the process of validating a replacement Glandular Fever screening kit (also supplied by Alpha Laboratories). An extension to scope will be submitted for this assay to be accredited at our next UKAS assessment in October 2018.

  • Notification of Change: Blood culture bottle change

    Item Author Robert Clarke

    The blood culture system used by the PHE Public Health Laboratory (provider of microbiology services to HEFT) is changing. During the week starting 15th January 2018, new blood culture bottles will be distributed to all relevant Trust wards and departments and the old bottles removed. The new blood culture bottles will be distributed in the usual kit format with a new butterfly needle and adapter cap to fit the new bottles. Please do not send the old style blood culture bottles after Monday 22nd January 2018 as the laboratory will be unable to process them. If you have any queries, contact the laboratory on Ext 43111 (0121 424 3111). .

    The assay has been validated and will be assessed by UKAS against ISO 15189 standards for accreditation as soon as possible.

  • Notification of Change: Measurement of Glucose-6-Phosphate-Dehydrogenase (G6PD)

    Item Author Mark Hill

    From Monday 27th November 2017, the Haematology Department will perform G6PD Assays for all G6PD requests using an assay kit from Pointe Scientific. Previously a screen was initially performed to identify if the activity was normal or reduced followed by an assay only in the event of a reduced screen. The assay method will also change from a manual method (30oC) to an automated method (37oC) on the Abbott Architect platform.

    The reference range will change and will be displayed on the report.

    There is no change to sample type or volume required.

    G6PD assay analysis will be performed in batches, twice weekly during routine hours. If a time critical result is needed please contact the laboratory (40908 / 0121 424 0908) and ask to speak to a Biomedical Scientist before sending a specimen to ensure that your sample is dealt with promptly.

    The assay was assessed by UKAS against ISO 15189 standards in October 2017 and we have received written confirmation that it meets the standards for accreditation. Awaiting update on UKAS website.