Haematology

Latest news from the Haematology Department

Notification of Change: Revision to PNH screen by Flow Cytometry

on Friday, 23 February 2018. Posted in Haematology

Notification of Change: Revision to PNH screen by Flow Cytometry

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.

Update on Blood Transfusion Service - HGS Pathology

Written by Craig Webster on Tuesday, 02 October 2018. Posted in Homepage, Haematology, General

Update on Blood Transfusion Service - HGS Pathology

On the 1st October 2018, the current UKAS accredited Blood Group and Antibody screen offered by HGS laboratories will no longer be performed on the Biorad blood grouping analysers. We are currently in the process of validating the replacement Grifols blood grouping analysers. An extension to scope has been submitted for this test to be accredited at our UKAS assessment in October 2018.

Update on Blood Films

on Thursday, 19 October 2017. Posted in Blood Sciences, Haematology

Blood smears are normally spread and stained using a process on an automated platform which has been accredited to ISO 15189 standards with UKAS. In the event of analyser failure blood smears are manually spread and stained using manual techniques which has been validated against the automated method but is not yet accredited by UKAS. This does not affect the interpretation of the morphology.

Change to Haematology Reference Ranges

on Friday, 27 May 2016. Posted in Haematology

Please note from June 1st 2016 the reference ranges for the full blood count will be changing, the most notable of which include haemoglobin, red cell count and neutrophil count.
New ranges:
RBC Male 4.3-5.7 *1012/L
Female 3.7-5.1*1012/L
Hb Male 133-166 g/L
Female 110-147g/L
Neutrophils 1.5-4.7 *109/L

 

The Erythrocyte Sedimentation Rate (ESR) reference ranges will also be changed from June 1st to reflect the new method used in the laboratory. These are as follows:
Age
2-14   2-34
15-50 (Female) 2-39
15-50 (Male) 2-30
51-70 (Female) 2-45
51-70 (Male) 2-44
>70 3-55

 


For more information regarding these changes please  contact the laboratory on extension 40908

 

 

Apixaban & Rivaroxaban

on Wednesday, 30 March 2016. Posted in Haematology

Haematology are now offering assays to measure the new oral anticoagulant drugs Apixaban and Rivaroxaban. Both drugs are direct factor Xa inhibitors. Apixaban is recommended by the National Institute for Health and Clinical Excellence for the prevention of stroke and systemic embolism in people with non-valvular atrial fibrillation and at least one of the following risk factors: prior stroke or transient ischemic attack, age 75 years or older, diabetes mellitus, or symptomatic heart failure. Apixaban and other newer anticoagulants (dabigatran and rivaroxaban) appear equally effective as warfarin in preventing non-hemorrhagic stroke in people with atrial fibrillation and are associated with lower risk of intracranial bleeding. For further information please contact the laboratory on 0121 424 0908 (internal ext 40908) or for clinical advice please contact the On Call Haematologist via switchboard.

New Laboratory

Written by Craig Webster on Saturday, 31 August 2013. Posted in Haematology, Biochemistry, General

New Laboratory

A video of the new laboratory at Birmingham Heartlands Hospital

Change in Glandular Fever screen

on Wednesday, 07 February 2018. Posted in Haematology

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: Measurement of Glucose-6-Phosphate-Dehydrogenase (G6PD)

on Thursday, 23 November 2017. Posted in Haematology

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.

Group and Save - Two Sample Rule

on Thursday, 01 September 2016. Posted in Haematology

With effect from 1st September 2016, Blood Bank are introducing the two sample rule for requests for blood and blood components (blood, fresh frozen plasma, cryoprecipitate, platelets, granulocytes).

What is the two sample rule?

Blood Bank need to ensure that there are two distinct samples from a patient that have generated the same blood group from both samples. If Blood Bank have seen the patient before and already have a historic blood group (after 20th October 2015) then you only need to make a request for group and save or X-match as you normally do. If the patient has no previous records in Blood Bank then you MUST repeat the group and save or X-match with a second sample.

Why is this rule being introduced?

Wrong blood in tube (WBIT) is a 'never event', it should not happen, however on occasions it does. The consequences of transfusing somebody with blood of the incorrect blood group is very serious and can lead to death. WBIT is a SHOT (Serious Hazards of Transfusion) reportable  incident. The two sample rule is a national guideline to improve patient safety when receiving transfusions.

How does the two sample rule work?

If the patient is not known to Blood Bank then the two sample rule is invoked. The two samples must come from separate venepuncture events and ideally should be carried out by two different people. Separate request forms should be completed for each sample. It is NOT acceptable to take two samples at one venepuncture event and send them to Blood Bank on separate request forms. This will not negate the possibility of WBIT. There is no limit on the time between samples as long as Blood Bank have a historic blood group on record after 20th October 2015.

How will I know if a second sample is required?

If you are unsure if Blood Bank already have a historic blood group you can check iCare or ICE for requests after 20th October 2015. If you are still unsure then please telephone Blood Bank on 40706 (BHH), 47279 (GHH) or 44527 (Sol).

What happens in an emergency situation?

If blood is required in an emergency eg massive bleed procedure invoked, the two sample rule will not apply however a second sample should be sent as soon as possible. Blood will be issued as per the massive bleed procedure and will not be delayed.

 

Change to Feto-Maternal Haemorrhage (FMH) Anti-D Calculation

on Wednesday, 27 April 2016. Posted in Haematology

From 25/04/16 we have adjusted the way Anti-D is calculated in our FMH screen by flow cytometry. The bleed is still reported in millilitres as previously however the suggested dose of Anti-D required to cover the bleed also takes into account the uncertainty of measurement of this technique in our laboratory. This may result in a slightly higher dose than expected but will ensure that bleeds are appropriately covered, especially those requiring multiple injections. For further information click here or contact the laboratory on 0121 42(40704)

Guidance on Testing for Paroxysmal Nocturnal Haemoglobinuria

Written by Mark Hill on Thursday, 08 January 2015. Posted in Haematology, General

Guidance on Testing for Paroxysmal Nocturnal Haemoglobinuria

Paroxysmal Nocturnal Haemoglobinuria (PNH) is an acquired haematopoietic stem cell disorder resulting in a partial or total deficiency of proteins normally linked to cell membranes by a glycosylphosphatidylinositol (GPI) anchor. Classical features are;

  • intravascular haemolysis
  • bone marrow failure
  • thrombotic tendency
  • may also include abdominal pain, dysphagia, erectile dysfunction, renal failure, lethargy

It can often go undiagnosed for months or even years. Flow cytometry can provide a definitive diagnosis.

Click here for further guidance on PNH testing. Contact the laboratory on 0121 424 0704.

Laboratory Information System Migration

on Thursday, 29 May 2014. Posted in Blood Sciences, Microbiology, Cellular Pathology, Haematology, Immunology, Biochemistry, General

Laboratory Information System Migration
In order to bring systems in line with the restructured laboratory services the Laboratory Medicine directorate will be migrating to new Laboratory Information System Databases for Blood Sciences and Microbiology.
 
The migration is due to commence at 8am Monday 2nd June.
 
No downtime is anticipated but there may be some temporary disruption as the migration progresses.
 
The Blood Sciences System will replace what is currently the separate disciplines of Chemistry, Haematology and Immunology as a single department. As such the ICE Reporting System will display reports as Blood Sciences (Orange highlighting).

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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