Annual Report 2010 - St. James's Hospital

Clinical Service Directorates I LabMed
collaboration with WHO and the Pan-American Health
Organisation (PAHO) for a study of folate status in Peru,
and has been invited by UNICEF to participate as advisor
in an international study in Kyrgystan.
Coagulation Laboratory and the National
Centre for Hereditary Coagulation Disorders
(NCHCD)
The Coagulation department in the Central Pathology
Laboratory provides a laboratory investigation service for
coagulation disorders for hospital inpatients and outpatients
as well as to General Practitioners and external hospitals.
The laboratory at the NCHCD examines samples from
patients within the hospital and also from referrals nationally
with suspected disorders associated with both bleeding and
thrombosis. Diagnosis of inherited and acquired disorders,
monitoring of therapy and screening for genetic disorders is
part of the examination repertoire in this laboratory.
barrow and mobilised peripheral blood stem cells, autologous
stem cells from mobilised peripheral blood or bone marrow
and donor lymphocytes. All stem cell products are processed
in the cryobiology laboratory clean room facility for immediate
usage (allogeneic) or cryopreserved and stored in vapour
phase liquid nitrogen (autologous) for directed usage.
Eight Medical Scientists, a Quality Manager and a Medical
Director staff the laboratory. A total of 216 bone marrow and
apheresis products units were harvested and processed in
2010. The total number of products processed and infused
was 294, this is a 12% increase on 2009. This increase is due
to the increase in the Allogeneic transplant numbers. In 2010,
sixty nine allogeneic transplants were performed. 30% (n=
37) of all transplants were from volunteer unrelated donors.
Collection of donated bone marrow or mobilised peripheral
blood is made possible by staff travelling to International
Collection Centres to collect the stem cells.
Service developments in Coagulation 2010
The routine coagulation laboratory underwent a successful
transition from its previous location within CPL to the core
automated laboratory in 2010. There was a 9% increase
in workload in this laboratory. Within the laboratory in the
NCHCD there was also an increase in workload, notably within
the molecular testing service for prothrombotic disorders.
A number of undergraduate and postgraduate research
projects were undertaken including the evaluation of new test
systems for the automated analysers as well as the laboratory
investigation of antithrombin defi ciency in a particular cohort of
patients. The analysis of the complex VWF gene for patients
with von Willebrand Disease was introduced.
Dr. Niamh O Connell was appointed Consultant Haematologist
at the NCHCD in 2010.
Cryobiology Laboratory Service 2010
The Cryobiology Laboratory Stem Cell Facility supports
the National Adult Stem Cell Transplant programme at St.
James’s Hospital and the Irish Unrelated Donor Bone
Marrow Programme.
The cryobiology laboratory is situated in a GMP clean room
facility leased from the Irish Blood Transfusion Service in the
National Blood centre. It contributes the laboratory component
to the Tissue Establishment, which supports the National
Adult Stem Cell Transplant Programme in the Hospital.
The Cryobiology Laboratory as part of the Tissue
Establishment holds a tissue licence from the Irish Medicines
Board to process and store allogeneic stem cells from bone
In 2010, the fi rst adult double cord transplant was performed
in St. James Hospital. The Tissue Establishment will be
applying to the IMB for a change of licence to include cord
transplantation as a therapeutic option in 2011.
The transfer of some of the cryopreserved product stock to
a licensed offsite storage facility was undertaken in 2010 and
the closure of the central pathology liquid nitrogen store room
was completed.
In 2010 Dr. Patrick Hayden was appointed as Medical
Director and responsible person of the Tissue Establishment
and Ms. Marie Foley retired as Quality Manager for the
Tissue Establishment.
Cancer Molecular Diagnostics
The Cancer Molecular Diagnostics (CMD) department
provides a molecular testing service for the identifi cation of
acquired genetic aberrations in cancer, particularly leukaemia
and lymphoma and, where appropriate, performs assessment
of minimal residual disease aiding the management of patients
with selected haematological malignancies. The laboratory
also provides testing support for both the national adult and
paediatric bone marrow transplant centres at St. James’s
Hospital and Our Lady’s Children’s Hospital respectively.
Laboratory service
A total of 4883 test requests were received by the CMD
laboratory in 2010, an overall increase of 10% as compared to
2009. Requests from clinical centres external to St. James’s
contributed to 68% of the workload, highlighting the national
role of the laboratory.
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