Blood Sciences

Blood Sciences combines the traditional pathology disciplines of Biochemistry, Haematology and Transfusion science. The Blood Sciences department is staffed 24 hours a day, 365 days of the year across four different hospital sites. Analysis of patient samples and clinical interpretation of results is carried out in several specialised laboratories by a highly skilled team of registered Biomedical Scientists, Clinical Scientists and Medics, supported by Medical Laboratory Assistants and Administrative staff.

Routine and emergency diagnostic testing is carried out using state of the art analysers linked to a comprehensive laboratory information system. This allows test results to be electronically requested and reported to primary and secondary care, thereby improving the overall quality of the process. Blood Sciences is a major regional and national referral centre for a broad range of specialist diagnostic services.

Our Transfusion laboratories cross-match blood and provide blood products for patients undergoing elective or emergency surgery and medical conditions requiring blood replacements.

For a comprehensive list of the tests that we offer, opening hours, phlebotomy information, reference ranges, telephone extension numbers and information for GPs, please follow the link to our Laboratory Handbook.

Biochemistry

Clinical Biochemistry (also known as Clinical Chemistry or Chemical Pathology) involves the study of the chemical and biochemical processes of the body in relation to disease.

We use a combination of modern analytical platforms, cutting edge analytical techniques such as ICP-MS and LC-MS/MS and established manual methods, to aid in the prevention, diagnosis and treatment of disease. The department also offers specialist testing services for referral investigations into bone metabolism, trace elements and endocrinology.

Clinical Scientific and Medical staff provide an expert interpretative service for biochemical test results and participate in a variety of ward rounds in the wider hospitals.

We have produced a Laboratory Handbook which contains a detailed breakdown of the complete range of services we offer in Biochemistry and is an invaluable first point of contact for information such as:

• The correct sample tube for the tests available
• Pre-sampling requirements (e.g. fasting patient)
• Reference Ranges
• Interpretation of results
• Advice on point-of-care devices
• Minimum patient data requirements
• Contact details for Laboratory staff members.

For a comprehensive list of the tests we offer, or for more information, please refer to the relevant Laboratory Handbook.

Coagulation

Our Coagulation laboratory is a regional reference centre for specialist investigations in the diagnosis and monitoring of haemostatic and thrombotic conditions such as Haemophilia and Lupus.

Working closely with the Roald Dahl Haemostasis and Thrombosis Centre (RDHT) at the Royal Liverpool University Hospital we provide the International Normalised Ratio  (INR) test for the monitoring of Warfarin therapy.

Testing is also offered for other anticoagulant treatments such as Heparin and Fragmin as well as clotting factor tests required for the support of Haemophiliac patients.

We also offer screening for blood clotting disorders.

For a comprehensive list of the tests we offer, or for more information, please refer to the relevant Laboratory Handbook.

Haematology Molecular Biology

The Molecular Biology Laboratory in Haematology offers a specialist diagnostic services for haematological myeloid and lymphoid malignancies.

The laboratory staff work closely with the Haematology medical staff in the investigation of samples referred for this diagnostic service.

Molecular tests for myeloid malignancies include:

• BCR-ABL fusion transcript screening and quantification,
• BCR-ABL kinase domain mutation,
• acute leukaemia recurrent translocation panel screening (28 translocations),
• FLT3 internal tandem duplicate (ITD) and kinase domain mutation,
• NPM1 mutation,
• FIP1L1-PDGFRA fusion transcript,
• SETBP1 mutation,
• c-KIT D816 mutation
• and MLL partial tandem duplicate (PTD).

Mutation tests for CEBPA, ASXL1, RUNX1, IDH1, IDH2, DNMT3A, JAK2 and CALR are in development and will be offered in the near future. Tests for lymphoid malignancies include (1). IGHV usage and somatic hypermutation status for CLL. (2). TP53 mutation in CLL. (3). CLL minimal residual disease (MRD).

An ultra-sensitive next generation sequencing to screen mutations in 15 genes relevant to CLL is under development and offered in near future.

For a comprehensive list of the tests we offer, or for more information, please refer to the relevant Laboratory Handbook.

Haemoglobinopathies

The Special Haematology laboratory is situated at Liverpool Clinical Laboratories (LCL) and undertakes investigations into inherited disorders of Haemoglobin and Red Blood Cells such as Sickle Cell Anaemia, Thalassaemia’s, and Glucose 6 – phosphate dehydrogenase (G6PD) deficiency.

Testing of Sickle Cell Anaemia and Thalassaemia is carried out using High-Performance Liquid Chromatography (HPLC) analysers. Where necessary, further confirmatory testing is performed using Haemoglobin Gel Electrophoresis and Sickle Solubility testing.

Most of the laboratory’s work comes from antenatal screening samples as part of the NHS Sickle Cell and Thalassaemia screening programme. The laboratory also regularly receives requests from the Haematology Department for monitoring patients with Sickle Cell Disease.

Glucose 6 – phosphate dehydrogenase (G6PD) is an enzyme that protects red blood cells from oxidative damage. Patients who have this deficiency are susceptible to haemolysis particularly when taking anti-malarial medication and antibiotics. At Liverpool Clinical Laboratories we provide G6PD qualitative screening, differentiating between normal and deficient samples.

For a comprehensive list of the tests we offer, or for more information, please refer to the relevant Laboratory Handbook.

Haemato-Oncology Diagnostic Service

LCL hosts the regional Haemato-Oncology Diagnostic Service (HODS) which provides a fully compliant Leukaemia and Lymphoma diagnosis, producing an integrated report from morphological immunophenotypic, cytogenetic and histological investigations.

The service is supported by a bespoke web-based IT system enabling clinicians to remotely view all test results into a single report.

For a comprehensive list of the tests we offer, or for more information, please refer to the relevant Laboratory Handbook.

Transfusion Services

Operating from 4 laboratories we carry out a number of key tests and services:

• Blood grouping and red cell antibody identification on patient samples, cross-matching compatible blood for patients suffering from medical conditions such as leukaemia or anaemia who need blood replacement therapy
• The supply of blood and blood components for elective or emergency surgical procedures or for patients admitted to the Accident & Emergency department having suffered serious blood loss
• The issuing of blood and platelets for patients requiring home transfusion by a specialist team of community nurses
• The supply of blood components such as fresh frozen plasma, platelets, albumin solutions, prophylactic anti-D and clotting factor concentrates
• Routine ante-natal blood grouping and antibody testing

As a regional referral centre for the live-threatening disorder Thrombotic Thrombocytopenic Purpura (TTP), we also hold a large stock of plasma suitable for urgent plasma exchanges.

We also work closely with the Bone Marrow Transplant and Haematology wards and the Haematology Day Care Unit at the Royal Liverpool Hospital; provide blood and blood component support for patients being treated at the Liverpool Heart and Chest NHS Foundation Trust and have an on-site laboratory at the Liverpool Women’s NHS Foundation Trust (LWH) which serves this specialist Obstetrics and Gynaecology hospital. The laboratory has an electronic blood tracking computer system installed to ensure the right blood for the right patient.

For a comprehensive list of the tests we offer, or for more information, please refer to the relevant Laboratory Handbook.

Blood and Marrow Transplantation

The number of conditions treated with haemopoietic stem cells has increased rapidly in recent years. In addition to bone marrow, alternative sources of haemopoietic progenitor cells such as mobilized peripheral blood donations or cord blood are being used increasingly.

LCL provides high quality stem cell preparations and related products for the purpose of stem cell transplantation. We also provide technical support for the José Carreras Transplant Unit at the Royal Liverpool and Broadgreen University Hospitals and the Oncology Unit at Alder Hey Children’s NHS Foundation Trust.

On receipt by the laboratory all donations are processed in sterile conditions in laminar airflow cabinets, located in a HEPA filtered clean room, and are converted into products appropriate for transplantation. The clean room is built to Good Manufacturing Practice standards. Personal protective clothing such as sterile polyester coats, clogs, hats and sterile gloves are worn at all times when working in the clean room.

The stem cell preparations and related products may be infused immediately or cryopreserved for later use.

For a comprehensive list of the tests we offer, or for more information, please refer to the relevant Laboratory Handbook.