Haematology Quality Group - Haematology Users' Handbook

University College London Hospitals
NHS Foundation Trust
HAEMATOLOGY AND BLOOD TRANSFUSION

USER HANDBOOK
Table of Contents
General Information ................................................................................................................................................................................................................................................ 3
Location .......................................................................................................................................................................................................................................3
Routine Laboratory Working Hours and Contact Numbers..........................................................................................................................................................3
Out-of-Hours Service ...................................................................................................................................................................................................................5
Urgent Requests ..........................................................................................................................................................................................................................5
Near Patient Testing facilities (Point-of-Care Laboratories).........................................................................................................................................................6
Clinical Advice..............................................................................................................................................................................................................................6
Vacutainer™ Guide......................................................................................................................................................................................................................7
Phlebotomy Services ...................................................................................................................................................................................................................8
Completion of the Request Form .................................................................................................................................................................................................9
Sample Collection ........................................................................................................................................................................................................................9
Sample Labelling .........................................................................................................................................................................................................................9
Sample Transport to the Laboratory ..........................................................................................................................................................................................10
Special Handling Requirements.................................................................................................................................................................................................10
Routine Haematology ........................................................................................................................................................................................................................................... 11
Blood Transfusion ................................................................................................................................................................................................................................................. 14
Requests for routine (scheduled) surgery ..................................................................................................................................................................................16
Transport of Routine Blood and Blood Products........................................................................................................................................................................16
Guidelines for Clinical Situations ...............................................................................................................................................................................................17
Routine Coagulation ............................................................................................................................................................................................................................................. 18
Haemostasis (Specialised Coagulation tests) ................................................................................................................................................................................................. 20
Special Haematology (Haemoglobinopathies) ................................................................................................................................................................................................ 26
Flow Cytometry (HIV and Cell Markers) ............................................................................................................................................................................................................ 29
Leukaemia Cytogenetics...................................................................................................................................................................................................................................... 33
HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 2 of 36

Author: Karen Orfinada, Sally McDonald (Senior Biomedical Scientists) Authorised by: Susan Crouch Haematology Management Group Review Date: May 2013
General Information
Location
The UCLH Haematology and Blood Transfusion laboratories are located at 60 Whitfield St, London W1T 4EU. Samples are sent from the main hospital to
Specimen Reception via the ‘Pod’ system and sample deliveries made by courier or from other sites are made via a rear building entrance in Howland Mews.
Near Patient Testing facilities for Haematology/Oncology patients are located on the 3rd Floor of the Rosenheim Building on Grafton Way and on the Lower
Ground Floor of the MacMillan Cancer Centre on Huntley Street.
Routine Laboratory Working Hours and Contact Numbers

The Haematology Autolab (routine Haematology and routine Coagulation) and Blood Transfusion laboratories are staffed 24 hours, 7 days per week.
Core hours are 9.00 – 17.15 Monday – Friday and 9.00 – 13.30 on Saturday. An out-of-hours service is provided outside core hours.
Core hours for specialist laboratories (Haemostasis, Special Haematology and Flow Cytometry) are 9.00 – 17.15 Monday – Friday.
Haematology Management Group 0203 447 9887 or x79887 9.00 – 17.15 Monday - Friday
Jenny Berryman Blood Transfusion Issues
Susan Crouch Haematology Operational Issues
Stefan Kunka Staffing and Finance
Training and Development Manager 0203 447 9887 or x79887 9.00 – 17.15 Monday - Friday
Stefan Kunka
Quality Compliance Coordinator 0203 447 9887 or x79887 9.00 – 17.15 Monday - Friday
Susan Crouch
Health & Safety Officer 0203 447 8533 or x78533 9.00 – 17.15 Monday - Friday
Norma McQueen
Haematology Autolab: Routine Haematology & Coagulation 9.00 – 19.15 Monday – Friday
9.00 – 13.30 Saturday
An out-of-hours service is provided.
Routine Haematology & General Enquiries 0203 447 8961 or x78961
Routine Coagulation 0203 447 8547 or x78547
Out-of-hours Bleep 7060
Departmental Lead: Billy Janda 0203 447 8961 or 78961 9.00 – 17.15 Monday - Friday

Blood Transfusion Laboratory 0203 447 8522/8523 or x78522/x78523 9.00 – 17.15 Monday – Friday
9.00 – 13.30 Saturday
Out-of-hours Bleep 7060 An out-of hours service is provided.
Blood Transfusion Laboratory Manager: Jenny Berryman 0203 447 8522/8523 or x78522/78523 9.00 – 17.15 Monday - Friday
Blood Transfusion Quality Manager: Jackie Barker 0203 447 8522/8523 or x78522/x78523 9.00 – 17.15 Monday - Friday
Blood Transfusion Training Officers: Sangeeta Samuel 0203 447 8550 or x78550 9.00 – 17.15 Monday – Friday
Lubna Awas 0203 447 8550 or x78550 9.00 – 17.15 Monday – Friday
MAJOR HAEMORRHAGE
For a Major Haemorrhage at any time: dial telephone extension 2222 (or extension 32222 from the Heart Hospital) and state "Major Haemorrhage" to the
switchboard operator to activate the UCLH Trust’s Major Haemorrhage Protocol. In the event of a telephone network failure: dial the Analogue Direct Telephone
Line to Blood Transfusion *020 7 631 0267, or Emergency Mobile *0771 851 2912.
Note, these telephone numbers are for emergency use only: any use of these lines for routine communication will be reported as a clinical incident.
Haemostasis Laboratory (Specialised Coagulation) 0203 447 8549/8529 or x78549/78529 9.00 – 17.15 Monday – Friday
Departmental Lead: Pamela Carr 0203 447 8545 or x78545
Special Haematology (Haemoglobinopathies) 0203 447 8533 or x78533 9.00 – 17.15 Monday - Friday
Departmental Lead: Norma McQueen
Flow Cytometry (HIV & Malignancy cell markers) 0203 447 9603 or x79603 9.00 – 17.15 Monday – Friday
Departmental Lead: Naina Chavda 0203 447 8541 or x78541
A limited Flow Cytometry service is available out-of-hours (subject to an out-of-hours technical agreement).
Leukaemia Cytogenetics: Samples are forwarded from the Flow Cytometry laboratory to external reference laboratories.
Returned reports are scanned onto CDR.

Medical Staff
Consultants
Professor Samuel J Machin (via secretary) 020 3447 9884 or ext 79884
Dr Hannah Cohen (via secretary) 020 3447 8563 or ext 78563
Professor Asim Khwaia 0207 679 6554
Professor David C Linch 020 3447 8483 or ext 78483
Dr Amit Nathwani 0207 679 6225
Dr Marie Scully 0207 025 7970
Professor John B Porter 020 3447 9638 or ext 79638
Dr Kwee L Yong 020 3447 8028 or ext 78028
On-call Consultant (out-of-hours) Contact via the on-call Haematology Registrar/SpR.
Specialist Registrars (9.00 – 17.00 Monday – Friday)
Haematology Laboratory SpR Bleep 7000
Blood Transfusion Laboratory SpR Bleep 7050
Haemostasis Laboratory SpR Bleep 7044
On-call Haematology Registrar/SpR (out-of-hours) Contact via Switchboard
Out-of-Hours Service
The Haematology Laboratory provides a 7 day / 24 hour restricted service outside of routine hours (i.e. after hours Monday – Saturday, Sunday and on Public
Holidays); a Biomedical Scientist can be contacted via the relevant Routine Haematology, Routine Coagulation or Blood Transfusion laboratory telephone
extension number until 19.15 Monday – Friday (see telephone numbers listed above), or via Bleep 7060 at any time.
The following services are available out of routine working hours:
• Full Blood Count (FBC), Erythrocyte Sedimentation Rate (ESR), Blood Film Examination, Malaria antigen testing.
• Clotting Screen / Fibrinogen Assay / D-Dimers
• Group and Antibody Screen for Pre-op/Crossmatch
• Crossmatch
• Pre-op sickle testing
Urgent Requests
Please contact the relevant laboratory during routine working hours, or Bleep 7060 outside routine working hours to alert laboratory staff to samples en route for
urgent processing.

Near Patient Testing facilities (Point-of-Care Laboratories)
Haematology Point of Care Laboratories provide Full Blood Count results exclusively for Haematology/Oncology outpatients receiving chemotherapy or
attending clinic appointments.
Rosenheim Building (University Street), 3rd Floor. 0203 447 8368 or x78368 8.30 – 17.00 Due to be closed by June 2012
MacMillan Cancer Centre (Huntley Street), Lower Ground Floor 0203 447 6855 or x76855 8.00 – 17.00
Clinical Advice
During routine working hours (Monday – Friday 9.00 – 17.00), please contact the relevant laboratory Specialist Registrar via the bleep system (contact numbers
are provided on page 5 of this user handbook).
A Haematology Registrar/SpR is on call outside routine working hours: contact via the switchboard.

Vacutainer™ Guide
Becton Dickinson Ordering information Tests / Screens
Vacutainer ™
EDTA FBC, ESR, Reticulocyte count, IPF, Blood film (note: ESRs cannot be performed on 7ml EDTA tubes),
4.5 ml Sickle screen, Malaria Antigen testing
Glandular Fever testing (note, Glandular Fever testing can be performed on an SST sample),
Lymphocyte subsets (including CD4, CD8 counts), Hereditary Spherocytosis Dye binding assay,
Plasma Viscosity
Blood Transfusion
*Group & Save (including antibody screen), *Crossmatch, Kleihauer, DAT
*Sample identification for Group & Screen or Crossmatch MUST be hand written with 4 correct points of ID.
Sodium citrate (citrated Clotting screen / Fibrinogen / D-Dimers For Paediatric Clotting Screens, see below.
tube)
4.5 ml Citrated Platelet Count (alert Coagulation laboratory staff that the sample is en route: it must not be centrifuged).
Note, underfilled samples Specialised Haemostasis tests must be authorised by a Haematology/Haemostasis SpR/Consultant
are unsuitable for testing. See the Haemostasis section below for the samples required for specialised Haemostasis tests.
SST Anti Cardiolipin antibodies (Antiphospholipid antibodies)

5ml β2GPI antibodies
Lithium Heparin Haemoglobinopathy screen, G6PD assay, Pyruvate Kinase assay, Red Cell Osmotic Fragility, Globin Chain
4.5 ml Biosynthesis, Oxygen Dissociation curve
Cytogenetic chromosomal analysis and FISH.
Sodium citrate (citrate) Paediatric Clotting Screen, Fibrinogen, D-Dimers (1ml tubes).
1.0 ml
These tubes must be filled exactly to the 1ml mark on the side of the tube: underfilled & overfilled samples are
unsuitable for testing.
These tubes are issued from the Haemostasis Laboratory to the Neonatal Unit, Paediatric A&E and Phlebotomy
Outpatient Departments and can be issued to other locations on request: contact x78549 or x78545 Monday –
Friday 9.00 – 17.15
Contact the Haemostasis laboratory regarding other Haemostasis tests for paediatric patients.

Phlebotomy Services
Phlebotomy Manager: Nahid Weaver 0203 447 0168 or x70168 7.30 – 16.30 Monday - Friday
Inpatient Services Outpatient Services

University College Hospital University College Hospital, 1st Floor Podium
Monday to Sunday 08:00 – 12:00 * Monday, Tuesday, Thursday, Friday 08.30 – 16.45
Wednesday 08.30 – 19.00
Heart Hospital Saturday, Sunday Closed
Monday to Sunday 08:00 – 12:00 *
Antenatal Clinic – UCH EGA wing (1st Floor)
Monday, Wednesday, Thursday 09:00 – 17:00
National Hospital for Neurology and Neurosurgery (NHNN) Inpatients
Tuesday 09:00 – 13:00
Monday to Friday 08:00 – 12:00 *
Friday, Saturday, Sunday Closed (samples collected by ANC staff).
* Note: Outside of these hours, staff trained in phlebotomy must
National Hospital for Neurology and Neurosurgery (NHNN) Outpatients
collect blood samples.
Monday, Tuesday, Thursday, Friday 09:00 – 17:00
Wednesday 09:00 – 18:00
Elizabeth Garrett Anderson wing (EGA) Saturday, Sunday Closed
No inpatient service
6th Floor, Rosenheim Building
GP Service Monday 13:00 – 16:30
UCLH GP Blood Test Suite Tuesday, Wednesday, Thursday 08:30 – 16:30
2nd Floor, Mortimer Market Centre, Mortimer Market WC1E 6JB Friday, Saturday, Sunday Closed
Mortimer Market runs off Capper Street, which is a side street off Tottenham
Court Road (across from Howland Street). Diabetic Clinic (UCH Podium, 1st Floor)
Monday to Friday 07:30 - 16:30 Monday * 13:00 – 17:00
* Clinics held every 2nd Monday only (appointments arranged by Diabetic Clinic staff).
Thursday 08:30 – 17:00
Travel Clinic
2nd Floor, Mortimer Market Centre, Mortimer Market WC1E 6JB
Mortimer Market runs off Capper Street, which is a side street off Tottenham
Court Road (across from Howland Street).
Monday, Tuesday, Wednesday, Thursday 09:00 – 17:00
Friday 09:00 – 13:00
Saturday, Sunday Closed

Completion of the Request Form
Please use the appropriate request form for the tests required and ballpoint (indelible) ink pen to complete the form.
• Please provide the patient’s full name, hospital number and date of birth.
• Please provide the date and time of sample collection and relevant clinical information to facilitate sample processing and the interpretation of results.
• Please use a separate Blood Transfusion request form for Blood Transfusion requests; Group & Save, Crossmatch, Kleihauer, DAT.
• Please ensure that the destination of the report, the name of the requesting/responsible clinician and a contact bleep/telephone number for the
responsible clinician is provided to enable laboratory staff to notify the clinician regarding unsuitable (urgent) samples and to relay and/or discuss urgent
or grossly abnormal results.
• Please tick the box next to the test(s) requested; if a required test is not listed, write it clearly into the “Additional Tests” section.
• Please tick the appropriate box when the patient is anticoagulated (on warfarin or heparin).
Please ensure that adequate samples are taken for the tests requested and that each sample is labelled correctly. Contact the relevant laboratory for
clarification of sample requirements if required.
Sample Collection
The sample collection policy for staff trained in phlebotomy [Haem-PD-BloodSampColl] and guidelines for sample labelling are available on the UCLH Intranet
and can be sent electronically to GP practices.
Sample Labelling
• Please label samples clearly with hospital number, first and last name and date of birth using a ballpoint (permanent/indelible) ink pen. The NHS number
may be used in place of the hospital number for GP and non-UCLH Trust patients.
• Samples for a Group and Save (including an antibody screen) and Crossmatching must be hand written with four correct points of ID. Please include the
time and date of collection and the signature of the person collecting the sample.
• A minimum of three points of identification must be provided for all other samples.
NOTE: Samples received broken/leaking, inadequately labelled, aged, clotted, haemolysed or otherwise unsuitable for testing will not be processed; an
appropriate comment will be entered onto the computer system. If the requested tests are urgent, laboratory staff will attempt to notify the ward/clinician.

Sample Transport to the Laboratory
UCLH samples: refer to the Pathology Specimen Transport and Pneumatic Tube System policies on the UCLH Intranet for hospital transport. Samples from GP
practices must be sent via UCLH Trust transport; via the next available collection during the working day. If a significant delay in sample transportation to the
laboratory is anticipated, please discuss with laboratory staff, as sample deterioration may limit the viability of results.
Special Handling Requirements

Please see the ‘Notes’ section in the test tables below, or contact the relevant laboratory for information regarding special handling requirements.

Routine Haematology Laboratory
Autolab. 1st Floor, Whitfield St Laboratories, 60 Whitfield St London W1T 4EU 0203 447 8961 or x78961 (Haematology) Bleep 7060 (out-of-hours)
0203 447 8547 or x78547 (Routine Coagulation)
• Please contact the laboratory for reference range(s) if not listed below:
Test Specimen Type Reference Key Factors Notes Out of Time Limit for Turnaround time
ranges affecting tests hours requesting from receipt of
service additional sample
tests from
time of
venesection
Acanthocytes 4.5ml EDTA 0-3 % Delay in receiving Send sample ASAP to the No service Within 24 24 hours
(can be sample laboratory as prolonged provided hours
performed on storage affects cell
same sample as Sample not kept at morphology
FBC) room temperature
Blood Film 4.5ml EDTA Not applicable Delay in receiving Send sample ASAP to the Service for Within 24 Urgent:
(can be sample laboratory as prolonged clinically hours 4 hours (not out of
performed on storage affects cell urgent hours unless the
same sample as Sample not kept at morphology requests laboratory is
FBC) room temperature contacted).
Please give clinical details / Non -urgent:
reason for request 24 hours
Citrated Platelet 4.5ml Sodium 150-400 x109/l Clot in sample Please indicate clearly on Service for Within 24 24 hours
Count (when in Citrate the request form that clinically hours
vitro platelet sample is for a citrated urgent
clumping occurs in platelet count. Notify the requests
EDTA samples) Routine Coagulation
Laboratory that the sample
is en-route: do not
centrifuge the sample.
ESR 4.5ml EDTA <40yrs: Clot in sample Can be performed on same Service for Within 24 Urgent:
(can be 1-7 mm/hr (F) sample as FBC if sample clinically hours 2 hours
performed on 1-5 mm/hr (M) Insufficient sample >3mls. urgent
same sample as ≥40yrs: Cannot be performed on a requests Non-urgent:
FBC) 1-20mm/hr Delay in receiving 7ml EDTA tube. 24 hours
sample

Routine Haematology Laboratory (page 2 of 3)
tests from
time of
venesection
Fluid Count Fluid to be Delay in receiving Please use “Urine/other” Service for Within 24 24 hours
(e.g. Pleural, taken into EDTA sample request form-specify type clinically hours
Ascitic, Knee fluid) or 10 or 20ml of fluid urgent
sterile container requests
Full Blood Count 4.5ml EDTA Adult WBC: Clot in sample > 1ml blood required Service for Sample must
3-10 x10 l
9 A&E: 1 hour
(FBC) Sample must be received clinically be received in
Neutrophils: Insufficient, within 12 hrs of collection urgent the laboratory
9
2-7.5 x10 /l Urgent: 1 hour
Lipaemic or Icteric requests within 12
Haemoglobin: samples Lipaemic/icteric samples hours of
11.5-15.5g/dl (F) Non-urgent:
13-17 g/dl (M) can affect performance of collection
Delayed sample test and may delay results 24 hours
MCV: 80-99 fl
Platelets: receipt
9
150-400 x10 /l
Glandular Fever 4.5ml EDTA Clot in sample Test can be added on to No service Within 7 days 24 hours
Screen Can be performed existing FBC sample (time provided
on FBC sample limit: 7 days)
or a 4.5 / 7ml
clotted sample
Immature Platelet 4.5ml EDTA 1.1 – 6.1% Clot in sample Test can be added on to Service for Within 24 24 hours
Fraction Can be performed existing FBC sample clinically hours
on FBC sample Delayed sample urgent
receipt requests
Malaria Antigen 4.5ml EDTA Clot in sample All samples for malaria Service for Within 24 Urgent:
Test Can be performed antigen tests are referred to clinically hours 1 hour
on FBC sample) Parasitology for urgent
confirmation requests Non-urgent:
-Please send requests for 2 hours
malaria parasite films and
% parasitaemia directly to
Parasitology laboratory

Routine Haematology Laboratory (page 3 of 3)
tests from
time of
venesection
Reticulocytes 4.5ml EDTA 20-100 x 109/l Clot in sample Test can be added on to No service Within 24 24 hours
Can be performed existing FBC sample (time provided hours
on FBC sample Delayed sample limit: 24 hours)
receipt
Sickle Screen 4.5ml EDTA Samples from All samples for sickle Service for Within 7 days Urgent:
(can be children < 6 months screens are referred to clinically 1 hour
performed on old can give false Special Haematology for urgent
same sample as negative results confirmation (if not requests Non-urgent:
FBC) previously confirmed) 24 hours
Anaemia
Formatted: Space Before: 6
Clot in sample pt
Referral Laboratory (Malaria testing)

Parasitology Laboratory
Hospital for Tropical Diseases Building
Capper St
London WC1E 6JA
0845 155 5000 ext 75418

Blood Transfusion Laboratory
1st Floor, 60 Whitfield St London W1T 4EU tel: 0203 447 8522 / 8523 or x78522 / 78523 (Routine hours) Bleep 7060 (out-of-hours).
MAJOR HAEMORRHAGE (see page 4 of this user manual)
• Samples and form MUST carry full and correct patient identification, i.e. handwritten forename, surname, date of birth and hospital number - requests
made without these details will not be accepted.
• Forms must be signed by both the requesting medical officer and the phlebotomist. The phlebotomist must sign and date the sample. Please provide a
bleep number for enquiries.
• Please refer to the Trust Blood Component Transfusion Policy and Procedure available on the UCLH Intranet.
Test Specimen Key Factors affecting Notes Out of Time Limit for Turnaround time from
type tests hours requesting receipt of sample
service additional
tests from
time of
venesection
Crossmatch 4.5ml/7ml Incorrectly labelled, Contact laboratory to check whether Service for Contact Urgent/STAT: 10 mins
EDTA Insufficient, clotted and valid Group & Save available in clinically Laboratory plus transport time (only if
haemolysed samples will laboratory before sending sample. urgent valid Group & Save
be rejected. requests sample available in
> 2ml required for adults laboratory).
Otherwise 45mins for full
>1ml required for neonates (<4 crossmatch or 10 mins
months) uncrossmatched from
receipt of sample in
laboratory plus transport
time.
*If antibodies are present,
turnaround time to be
determined on a case by
case basis.
Non-urgent: same day
non-emergency
crossmatch: 2 hours plus
transport time.
*If antibodies are present,
turnaround time to be
determined on a case by
case basis.

Blood Transfusion Laboratory (page 2 of 4)
service additional
tests from
time of
venesection
Direct 4.5 /7ml Can be added onto existing Group & Service for Within 5 days Urgent: 30mins from receipt
Antiglobulin EDTA Save or Haematology FBC sample clinically of sample in laboratory
Test (DAT) urgent Non-urgent:
requests 24hrs
Group & Save 4.5/7ml Insufficient, clotted and >2ml required for adults Service for Sample must Urgent: 30mins from receipt
EDTA haemolysed samples will clinically be received in of sample in laboratory
be rejected. >1ml required for neonates (<4 urgent the laboratory Non-urgent:
months) requests within 12 hours 24hrs
of collection
Kleihauer 4.5ml EDTA Delay in receiving Sample should be ideally collected Service for Within 5 days 24 hours
sample. within 2 hours of delivery or clinically
sensitising event and MUST be urgent
Sample not kept at room tested within 24 hours (including requests
temperature before Saturdays and Sundays)
performing test.
Antenatal: 7-10ml Referred to Red Cell No service Additional 3 working days
Anti D/c EDTA + Immunohaematology Department, provided EDTA samples
quantitation sample for North London Blood Transfusion are required
Anti-K titre Group & Centre (NLBTC) for test,
Save contact the
Samples sent on Friday will not be laboratory.
collected by NLBTC until Monday
HLA and 7-10ml Referred to Histocompatibility and No service Additional 5-7 working days
disease EDTA Immunogenetics Department, provided EDTA samples
association NLBTC are required
(e.g. HLAB27) for test,
Samples sent on Friday will not be contact the
collected by NLBTC until Monday laboratory.

service additional
tests from
time of
venesection
HLA typing 7-10ml Referred to Histocompatibility and No service Additional 5-7 working days
EDTA Immunogenetics Department, provided EDTA samples
(if white cell NLBTC are required
count <2 for test,
x109/l send Samples sent on Friday will not be contact the
double collected by NLBTC until Monday laboratory.
volume of
blood)
Referral laboratories:
Red Cell Immunohaematology Histocompatibility and Immunogenetics
North London Blood Transfusion Centre North London Blood Transfusion Centre
Charcot Road Charcot Road
London NW9 5BG London NW9 5BG
0208 957 2831 0208 957 2812
Requests for routine (scheduled) surgery
• Requests must be received in the laboratory by 1900hrs on the day before surgery
• Samples received after this time will be prioritised by order of the theatre list. Emergency cases will take priority.
• Requests for routine surgery should comply with the local Maximum Surgical Blood Ordering Schedule (MSBOS). Refer to the Trust Blood Transfusion
Manual on the intranet.
Transport of Routine Blood and Blood Products
Cross matched blood and other blood products are dispatched as follows:
• Non-urgent blood and blood products are dispatched from the laboratory at various times during the day.
• Urgent blood and blood products are dispatched from the laboratory by courier (arranged by the laboratory). PLEASE CONTACT THE LABORATORY
(x78523/78522 during routine work hours or Bleep 7060 out of hours) IF BLOOD IS REQUIRED URGENTLY.
• Crossmatched blood is returned to the laboratory two days after the original date required unless the laboratory is requested to extend the time.
Extension of blood availability depends on whether the patient has been transfused as a new sample may be required for crossmatching.
• Unused platelets/FFP/Cryoprecipitate are withdrawn the day after the original date required
*Always ring the laboratory before use of EMERGENCY UNCROSSMATCHED BLOOD*

Guidelines for Clinical Situations
1. Life threatening haemorrhage (acute massive blood loss) Massive obstetric haemorrhage
Refer to the Major Haemorrhage Algorithm
http://insight/departments/MedicineBoard/Pathology/HaematologyPathology/BloodTransfusion/Documents/Major%20haemorrhage%20algorithm.pdf
For further Information refer to the Trust Major Haemorrhage Protocol
http://insight/guidelines/Clinical%20guidelines/Major%20Haemorrhage%20Protocol%202012.pdf
2. Non-acute bleeding and neonatal surgery
Obtain: Coagulation screen and FBC

Contact: Blood Transfusion Registrar
Monday →Friday 09:00-17:00: All other times:

UCLH Bleep 7050/7000 General Haematology Registrar via UCLH switchboard
Discuss: Appropriate treatment

(If a high risk procedure, or the patient has a known coagulation abnormality, contact the Haemostasis Registrar prior to
procedure and discuss the patient’s management)
Monday →Friday 09:00 – 17:00 All other times:
Haemostasis Registrar UCH Bleep 7044/7000 General Haematology Registrar via UCH Switchboard
3. Indications for the transfusion of red cells, FFP, cryoprecipitate and platelets
Please refer to the relevant chapter/appendix in the Trust Blood Component Transfusion Procedure Manual
http://insight/departments/MedicineBoard/Pathology/HaematologyPathology/BloodTransfusion/Documents/Blood%20and%20Blood%20Component%20Tran
sfusion%20Manual.pdf
4. Patients with Special Transfusion Requirements

For patients who may require CMV negative blood products, Irradiated blood products, Washed red cells and/or HLA matched platelets:
Please refer to the relevant appendix in the Blood Component Transfusion Procedure Manual. Ensure that the laboratory has received a Blood
Transfusion Status Form by emailing BT Status or by faxing to fax number 0203 447 9587 before requesting blood products (this form can be downloaded
from the Blood Transfusion site on the UCLH intranet).

Routine Coagulation Laboratory
Autolab 1st Floor, Whitfield St Laboratories, 60 Whitfield St London W1T 4EU tel: 0203 447 8547 or x78547. Bleep 7060 (out-of-hours).
• Citrated samples must be adequately filled (a 9:1 blood:citrate sample ratio is required for all citrated samples). Tests cannot be performed on
underfilled, overfilled, haemolysed or clotted samples.
• Paediatric citrated tubes are issued from the Haemostasis Laboratory to the Neonatal Unit, Paediatric A&E and Phlebotomy Outpatient departments and
can be issued to other locations on request: contact x78549/78545 during routine hours.
• Include clinical details on the request form, e.g. “patient receiving Warfarin/Heparin therapy” or “post op”; to facilitate appropriate testing and
interpretation of results.
• Send the request form and sample to the laboratory as rapidly as possible; notify the laboratory regarding very urgent requests on ext 78547 (during
routine working hours) or Bleep 7060 (out of hours).
• Grossly lipaemic samples may require manual testing, potentially delaying results.
• Abnormal results that require further laboratory investigation and/or manual testing/confirmation may be delayed.
Test Specimen Key Factors Note Reference Range Out of hours Time Limit Turnaround time
type affecting tests service for from receipt of
requesting sample
additional
tests from
time of
venesection
Coagulation 4.5ml Sodium Heparin & warfarin PT: 10-12 secs Service for 5 hours Formatted: Space Before: 6
Heparin & A&E: 1 hour pt
screen Citrate therapy affects results APTT: 22-41 secs clinically urgent
Warfarin.
PT/INR, APTT, TT and determines TT: daily control TT requests
Urgent: 1 hour
Delayed receipt of appropriate testing +/- 2 secs
sample. please indicate that the Non-urgent: 2 hours
patient is on heparin
and/or warfarin on the
request form.
Fibrinogen 4.5ml Sodium Delayed receipt of This test can be added Service for 5 hours
1.5 – 4.0 g/L A&E: 1 hour
Citrate sample. for an existing citrated clinically urgent
May not be sample. requests Urgent: 1hour
possible on
grossly lipaemic Non-urgent: 2 hours
samples.

Routine Coagulation Laboratory (page 2 of 2)
Test Specimen Key Factors Note Out of hours Time Limit Turnaround time
type affecting tests service for from receipt of
requesting sample
additional
tests from
time of
venesection
D-dimers 4.5ml This test can be added Normal cut off: Service for 5 hours
Urgent: 1hour
Sodium for an existing citrated 0 – 0.55 mg/L FEU clinically urgent
Citrate sample. DVT/PE cut off: requests
Non-urgent: 2 hours
< 0.50 mg/L FEU
(Unfractionated) 4.5ml Sodium Delayed receipt of Please indicate Heparin Therapeutic range: Service for 5 hours
Urgent: 1hour
Heparin Citrate sample. therapy on the request 2.0 – 3.0 clinically urgent
Monitoring: APTT form (tick box or requests
Non-urgent: 2 hours
ratio handwrite).
INR 4.5ml Sodium Delayed receipt of Please indicate Warfarin Overall range: Service for 5 hours
A&E: 1 hour
Citrate sample. therapy on the request 1.5 – 4.5 clinically urgent
form (tick box or An individual requests
Urgent: 1hour
handwrite). patient’s target
range is a clinical Non-urgent: 2 hours
decision: contact
the Anticoagulation
Clinic (ext
75222/x79139, 9-5
Mon-Fri) for target
ranges or seek
advice from the
Haemostasis SpR
on bleep 7044
(during routine
hours) or via the
switchboard (out-
of-hours).

Haemostasis Laboratory (Specialised Coagulation tests)
2nd Floor, 60 Whitfield St London W1T 4EU Hours: 09.00 – 17.15 Monday – Friday tel: 0203 447 8545 / 8549, x78545/78549
Bleep 7060 (out-of-hours).
All Haemostasis tests must be requested/authorised by the Haemostasis SpR (Bleep 7044), Haematology SpR (Bleep 7000) or Haematology Consultant, with
the exception of the following:
Anti Cardiolipin Antibody testing;
Plasma Viscosity measurement;
Thrombophilia Screens from the Hyper Acute Stroke Unit (HASU) and the National Hospital for Neurology and Neurosurgery;
Antiphospholipid Antibody Screens from Rheumatology Outpatients (Professor Isenberg’s Clinic).
Please discuss requests with Haemostasis laboratory staff if necessary, to ensure adequate and appropriate samples are collected.
Citrated samples must be adequately filled (a 9:1 blood:citrate sample ratio is required for all citrated samples).
Tests cannot be performed on underfilled, overfilled, haemolysed or clotted citrated samples.
Paediatric citrated tubes are issued from the Haemostasis Laboratory to the Neonatal Unit, Paediatric A&E and Phlebotomy Outpatient departments and
can be issued to other locations on request: contact x78549/78545 during routine hours.
• Include clinical details on the request form to facilitate appropriate testing and interpretation of results.
• Send the request form and sample to the laboratory as rapidly as possible; plasma must be processed within 5 hours of venepuncture.
• For very urgent requests, notify the laboratory staff on ext 78549 / x78545 (during routine working hours) or Bleep 7060 (out of hours).
• Additional tests are available - to be requested by a Haematology SpR/Consultant or Haemostasis laboratory Biomedical Scientist as appropriate.
Test Specimen type Key Factors Notes Reference Out of hours Time Limit for Turnaround
affecting Range service requesting time from
tests additional receipt of
tests from sample
time of
venesection
Antiphospholipid Warfarin and The Dilute Russell’s Viper Contact the No out of Contact the 10 working
Antibody Screen / heparin Venom Time (DRVVT) test is laboratory hours service Laboratory days (Lupus
2 x 4.5 ml Sodium therapy. performed to test for the regarding Anticoagulant
Lupus Screen
incorporates Lupus Citrate samples Lupus Anticoagulant; a Lupus test)
Delayed Taipan Venom Time (TVT) Anticoagulant
Anticoagulant and
testing and receipt of test is performed for patients testing. 10 days
Cardiolipin 1 x 5ml SST sample samples on warfarin. (Cardiolipin
(Lupus Refer to Antibodies)
Antibody testing
Anticoagulant Lupus Anticoagulant testing Cardiolipin
test). is inappropriate when Antibody
patients are receiving heparin testing.
therapy.

Haemostasis Laboratory (Specialised Coagulation tests) (page 2 of 6)
tests from sample (in
time of working
venesection days for non
urgent
requests)
Anti-Xa assay 1 x 4.5ml Sodium Delayed Samples should be collected Therapeutic By Contact the 5 working
Citrated sample receipt of 4 hours post an injection of range: 0.35 agreement Laboratory days
For monitoring low sample. Low Molecular Weight – 0.70 IU/ml. with the
molecular weight Heparin. Haematology
heparin -LMWH) Individual Consultant
therapy. patient’s on call and
target range subject to
is a clinical staff
decision. availability.
β2 Glycoprotein 1 1 x 5ml SST sample A single SST sample is IgG: < 10 No out of Contact the 10 working
Antibodies sufficient for ACLA & B2GPI U/ml hours service Laboratory days
(B2GPI) Antibody testing.
IgM: < 6 U/ml
Bleeding screen 3 x 4.5ml Sodium Heparin Platelet Aggregation Studies FVIII: Factor VIII Contact the 10 working
Citrated samples affects the must be requested separately 0.50 – 2.00 only, by Laboratory days
von Willebrand FVIII result. if required. IU/ml agreement
Factor Antigen, with the
Ristocetin Co- Recommendation: Delayed VWFAg: Haematology
factor also send an EDTA receipt of 0.50 – 1.60 Consultant
sample for a FBC. samples. IU/ml on call and
and
VWFRic: subject to
Factor VIII assays. 0.50 – 2.00 staff
IU/ml availability.
Cardiolipin 1 x 5ml SST sample This test does not require IgG: ≤ 12 No out of Contact the 10 days
Antibodies authorisation. GPLU/ml hours service laboratory
(ACLA) IgM: ≤ 12
MPLU/ml

tests from sample
time of
venesection
Factor Assays 4.5ml Sodium Heparin and Specific factor assays must Contact the Factor VIII Contact the 10 working
Citrated samples – Warfarin. be requested on the request laboratory and Factor IX Laboratory days
FVIII, FIX, FXI, form. only: by
FXII contact the Acute illness agreement
laboratory for the (contact the
FII, FV, FVII, FX with the
number of samples laboratory). Haematology
required (dependent
FXIII Delayed Consultant
on the tests
receipt of on call and
requested).
samples. subject to
staff
availability.
Lupus 3 x 4.5ml Sodium Heparin and Lupus Anticoagulant testing Contact the No out of Contact the 10 working
Anticoagulant Citrated samples Warfarin is inappropriate when laboratory hours service laboratory days
test patients are receiving heparin
Delayed therapy.
Dilute Russell’s receipt of
Viper Venom Time samples. An SST sample is required if
test Cardiolipin Antibody testing is
also requested.
or Taipan Venom
Time test (on
warfarin).
Heparin induced 1 x 4.5ml Sodium Urgent test: This test MUST be Contact the By agreement Contact the Non-urgent:
thrombocytopaenia Citrated sample send the authorised by a laboratory with the Laboratory 5 working
(HIT) screen (preferred) – the test sample to the Haematology Consultant Haematology days
can be performed on lab. (i.e. not an SpR): contact via Consultant
Heparin:PF4 a Coagulation Immediately. on call and
the Haematology SpR Urgent:
antibody assay Screen sample. subject to 1 working
(bleep 7044/7000) or
or switchboard out of hours. staff day
availability.
1 x 5m SST sample.

time of working
urgent
requests)
PFA-100 1 x 4.5ml Sodium Aspirin The sample must be kept Contact the No out of Contact the 1 working
Citrated sample affects between 15 – 25°C and laboratory hours service Laboratory day
(Platelet function results. tested within 5 hours.
analysis) Recommendation:
also send an EDTA Delayed Platelet Aggregation Studies
sample for a FBC) receipt of must be requested separately
sample. if required.
Variations in
temperature.
Significant
thrombocytop
enia,
anaemia,
leucopaenia.
Plasma viscosity 1 x 4.5ml EDTA Variations in Samples must be kept 1.50 - 1.72 By 7 days 4 working
sample temperature between 15 – 25°C. mPa agreement days
with the
Delayed Samples that have been Haematology
receipt of refrigerated or warmed are Consultant
sample unsuitable for testing. on call and
subject to
staff
availability.

time of working
urgent
requests)
Platelet 7 x 4.5ml Sodium Aspirin Samples must be kept Contact the No out of Tests must be 1 working
Aggregation Citrated samples affects between 15 – 25°C and laboratory hours service performed day
studies platelet received by the lab within 1.5 within 5
( 2 x 4.5ml Sodium aggregation: hours of
hours of phlebotomy and
and/or Citrated samples if testing is not venepuncture.
before 12.00 hrs.
Platelet Nucleotide recommended
Platelet studies are while patient
Nucleotide requested only). is on aspirin.
studies
Delayed
receipt of
samples.
Recommendation:
also send an EDTA Variations in
sample for a FBC) temperature.
Significant
thrombocytop
aenia:
aggregation
studies are
only possible
with an
adequate
platelet
count.

time of working
urgent
requests)
Thrombophilia 4 x 4.5ml Sodium Delayed These tests require Contact the Antithrombin, Contact the 10 working
screen Citrated samples receipt of authorisation unless the laboratory Protein C Laboratory days (plus a
+ samples. patient is a Haematology, and Protein S further 5
Antithrombin, 1 x 5ml SST sample NHNN or HASU patient: for only, by days if
Protein C, + Plasma must all other patients, please agreement genetic
Protein S, 1 x 4.5ml EDTA be processed contact the Haemostasis or with the testing is
Lupus within 5 Haematology SpR (bleep Haematology required).
Anticoagulant, hours of 7044 or 7000) for Consultant
Cardiolipin venesection. authorisation before taking on call and
Antibodies, Warfarin and samples. subject to
Activated Protein C Heparin staff
Resistance (& These tests can be requested availability.
Factor V Leiden Acute illness individually.
genotyping if may affect
indicated). results of
Also Factor VII and some tests
X assays when
patients are on
warfarin.
Additional tests are available - to be requested by a Haematology SpR/Consultant or Haemostasis laboratory Biomedical Scientist as appropriate.
Referral Laboratories:
For XIII assays, Nucleotides, PF1.2 and TAT (Thrombin antithrombin complex) For VWF Multimers
Haemostasis Research Unit Haemophilia Centre and Thrombosis Unit
Department of Haematology Ground Floor
University College London Hospitals Royal Free Hospital
1st Floor, 51 Chenies Mews London WC1E 6HX Pond Street London NW3 2QG

Special Haematology Laboratory (Haemoglobinopathies)
2nd Floor, 60 Whitfield St London W1T 4EU Hours: 09.00 -17.15 Monday - Friday tel: 0203 447 8533 or x78533
• Haemoglobinopathy & Haemolytic Anaemia investigations
• Reference ranges are provided on the report and on the IT system.
Test Specimen type Key Factors Notes Out of hours Time Limit for Turnaround
affecting tests service requesting time from
additional receipt of
time of working days)
venesection
Haemoglobinopathy 4.5ml EDTA/Lithium Age of sample Can be performed on FBC No service Within 7 days Urgent:
screen heparin + sample for sample provided 2 hours
FBC
Non urgent:
3 working days
from sample
receipt if no
further tests
required.
%Hb S levels 4.5ml EDTA/Lithium Can be performed on FBC No service Within 7 days Urgent:
heparin sample provided 2 hours
Non urgent:
3 working days
from sample
receipt
G6PD levels 4.5ml EDTA or Lithium Sample not Recent blood transfusion can No service Within 7 days Urgent:
heparin stored at 2-6 °C invalidate the result. Please provided 2 – 4 hours
indicate if patient has been
transfused recently. Non urgent:
2 working days
Pyruvate Kinase 4.5ml Lithium heparin Sample not Recent blood transfusion can No service Within 7 days 5 working days
levels stored at 2-6 °C invalidate the result. Please provided
indicate if patient has been
transfused recently.

Special Haematology Laboratory (Haemoglobinopathies) (page 2 of 3)
time of working days)
venesection
Haemoglobin H stain 4.5ml EDTA or Lithium Age of sample Samples greater than 48 hours No service Within 7 days 2 working days
heparin old are unsuitable for this test. provided
Heinz Body 4.5ml EDTA or Lithium Age of sample Samples greater than 48 hours No service Within 7 days 2 working days
Preparation heparin old are unsuitable for this test. provided
Hereditary 4.5ml EDTA Age of sample Please arrange with laboratory No service Within 8 hours 3 working days
Spherocytosis provided
Dye Binding Assay Samples greater than 24 hours
old are unsuitable for this test.
Red Cell Osmotic 4.5ml Lithium heparin Please arrange with laboratory No service Within 8 hours 3 working days
Fragility provided
Red Cell Oxygen 4.5ml Lithium heparin Please arrange with laboratory No service Within 8 hours 2 working days
Dissociation provided
Globin Chain 3 x 4.5ml Lithium Please arrange with laboratory No service Within 8 hours Urgent:
Biosynthesis heparin (10ml blood provided 5 working days
required)
Non urgent:
10 working Formatted: Left
days
Haemoglobinopathy 2 - 4 x 4.5ml EDTA Referred to Haemoglobinopathy No service Additional 2-20 working
DNA and (10 - 20ml blood Genetics, UCLH provided samples are days
Haemochromatosis required) required for
test.
Erythropoietin 7ml clotted sample Via Haematology consultant. No service Additional 10 -15 working
Referred to Kings College provided samples are days
Hospital required for
test.

Special Haematology Laboratory (Haemoglobinopathies) (page 3 of 3)
tests from sample
time of
venesection
Soluble Transferrin 7ml clotted sample Via Haematology Consultant. No service Additional 4-8 weeks
Receptor assay Referred to Kings College provided samples are
Hospital required for
test.
Transcobalamin 7 ml clotted sample Referred to Royal Free Hospital. No service Additional 4-6 weeks
Sample must be separated within provided samples are
2 hours and posted to Royal free required for
Hospital test.
Liver Dry Iron Biopsy sample in Referred to Royal Free Hospital. No service Additional 2-6 weeks
Estimation Formalin provided samples are
required for
test.
Referral Laboratories:
Haemoglobinopathy Genetics Department of Clinical Chemistry Special Haematology For Paroxysmal Nocturnal Haemoglobinuria:
86-96 Chenies Mews Kings College Hospital Royal Free Hospital Haematological Malignancy Diagnostic Service
London WC1E 6HY Denmark Hill, Pond Street Level 3 Bexley Wing
08451 555 000 ext 5230 London SE5 9RF London NW3 2QG St James University Hospital
0207 737 4000 ext 3501 0207 794 0500 ext 33413 Beckett Street
LEEDS LS9 7TF

Flow Cytometry Laboratory (HIV and Cell Markers)
2nd Floor, 60 Whitfield St, London W1T 4EU Hours: 09.00 – 17.15 Monday – Friday tel: 0203 447 9603 or x79603. Bleep 7060 (out-of-hours)
• Please see report/telephone laboratory for reference ranges
Test Specimen Type Key Notes Out of hours Time Limit Turnaround
Factors service for time from
affecting requesting receipt of
tests additional sample (in
tests from working days)
time of
venesection
Acute Leukaemia Bone Marrow in EDTA Sample not Please discuss with Haematology There is an out-of- Within 24 24hrs. For urgent
screen. This includes (2-4 EDTA samples) kept at SpR (Bleep 7000/7001) before hours technical hours samples results
Myeloperoxidase stain, (can be performed on room sending. agreement in place. can be sent out
Esterase stain and Tdt. peripheral blood if temperature within a few
bone marrow is not be . Please send samples directly to hours after being
available) Flow Cytometry laboratory. received in
Pleural, laboratory
Ascites and Please let flow cytometry
No minimum volume. laboratory know to expect
CSF
samples not sample.
Analysis can also be
carried out on CSF, being spun Transport samples at room
pleural and ascites onto slides temperature.
fluid. within 12
hours of
being taken.
Chronic Leukaemia Peripheral Blood in Sample not Please send samples directly to No service provided Within 24 24hrs. For urgent
screen EDTA (1-2 EDTA kept at flow cytometry lab. hours samples results
samples). room can be sent out
temperature Please let flow cytometry within a few
Can be performed on laboratory know to expect the hours after being
BM, CSF, pleural fluid samples. received in
and Ascites fluid. laboratory.
Transport samples at room temp.
No minimum volume.
Flow Cytometry Laboratory (HIV and Cell Markers) (page 2 of 4)

time of
venesection
Lymphoma screen Bone Marrow or Sample not Please send samples directly to No service provided Within 24 24hrs. For urgent
Peripheral Blood (2-4 kept at flow cytometry lab. hours samples results
EDTA BM or PB room can be sent out
samples) temperature Please let flow cytometry within a few
laboratory know to expect hours after being
(Can be performed on sample. received in
existing FBC sample) laboratory.
Transport samples at room
No minimum volume. temperature.
Bone Marrow staining 8 x bone marrow If BM in The laboratory registrar / SHO BM received out of Within 24 Urgent ( i.e.
smears EDTA has should be contacted for bone hours are not hours ?Acute
been marrow requests. Slides must be stained. If BM are Leukaemia):
received labelled in pencil with at least 3 urgent and need to 1hr for staining +
instead of points of patient id and the date of be looked at out of same day for
slides sampling. hours, please bleep reporting by
on-call laboratory Haem
staff to let them SpR/consultant
know to stain slides. Non-urgent:
24hrs for staining
+ further 4
working days for
reporting by
Haem
consultant/
SpR

time of
venesection
Lymphocyte subsets for 1 x 4.5ml EDTA Clotted Please discuss all HIV negative No service provided Within 24 24hrs
HIV monitoring and for sample requests with Haem SpR (Bleep hours
haematology patients. (Can be performed on 7000/7001)
existing FBC sample) Sample not
kept at Samples should be <24hours old.
room
temperature Samples received after 1600hrs
will not be processed till the next
working day
CD19 4.5ml EDTA Clotted Transport at room temperature. No service provided Within 24 24hrs
(for patients receiving sample hours
anti-CD20 Rituximab) (Can be performed on
existing FBC sample) Sample not
kept at
room
temperature
Paroxysmal Nocturnal 4.5ml EDTA Sample not Please discuss with Haematology No service provided Within 24 24hrs
Haematuria screen kept at SpR (Bleep 7000/7001) before hours
(can be performed on room sending. Please send samples
(All samples that need existing FBC sample) temperature directly to laboratory.
to be referred to Leeds
must be sent to Special Transport samples at room
Haematology) temperature.

time of
venesection
Cerebrospinal Fluid CSF in 10/20ml sterile Sample not Please ensure samples arrive in All CSF requests Within 24 24hrs
(CSF) cytospin container kept at laboratory no later than 1630hrs. received out of hours (same day)
room hours will be partially
No minimum volume temperature (If white cells are seen upon processed but not
microscopic examination of reported. If they
cytospin slides, they are referred need to be looked at
to Haem SpR for verification) out of hours the on-
call lab staff need to
be contacted.
Iron stain 8 x Bone Marrow If BM in Slides must be labelled in pencil No service provided Within 24 24hrs
Slides EDTA has with at least 3 points of patient id hours
been and the date of sampling.
received
instead of
slides
Urinary Haemosiderin 10mls urine None Haemosiderin can persist in the No service provided Within 24 48 hrs + 2
urine for weeks following a hours working days for
haemolytic episode report by Haem
SpR
Pleural or Ascites fluid 1ml fluid in sterile If sample is Please contact flow cytometry No service provided Within 24 24 hours.
container more than staff when sending. hours
24 hours

Leukaemia Cytogenetics (Referral Service)
2nd Floor, 60 Whitfield St London W1T 4EU 09.00 – 17.00 Monday – Friday (Referral service only) tel: Flow Cytometry: 0203 447 9603 or x79603
All samples for Leukaemia Cytogenetics are sent from the Flow Cytometry Laboratory to referral Laboratories.
Test Specimen type Key Factors Notes Out of Time Limit Turnaround
affecting tests hours for time from
service requesting receipt of
additional sample (in
tests from working
time of days)
venesection
Cytogenetic (chromosomal Bone Marrow Poor sample Analysis will be carried as No N/A 10 working
analysis) quality (clotted appropriate or in consultation with service days for
-Testing for suspected Peripheral Blood: or more than a the referring Consultant or provided diagnostic
haematological disease disorders 5-10ml day old) Registrar. AML, ALL
(at presentation, post therapy or and CML’s
bone marrow transplant). Samples should Sample Transport to laboratory as soon
be in Lithium transported as possible before 1630hrs. 15 working
Aplastics/ general anaemia Heparin or and or stored days for all
Acute Myeloid Leukaemia – Cytopots (RPMI above or below The samples may be left other routine
M1,M2,M3,M4,M4Eo,M5 1640 + Heparin room overnight at room temperature tests.
A.L.L medium). Except temperature and delivered to laboratory
Burkitt’s Lymphoma for CD138+ immediately the following
CLL isolated plasma Sample morning.
CML cells for FISH on Contaminated
Diffuse Large B cell Lymphoma multiple myeloma by bacteria
ET cases.
Follicular Lymphoma
Mantle cell lymphoma
Sample taken
MDS (CMML/RA/RARS/RAEB) into wrong
Myelofibrosis transport
Multiple Myeloma medium
MPD (ITP/Polycythaemia)
NHL
Pancytopenia
Plasma cell Leukaemia
PRV
Thrombocytopenia/Neutropenia

Leukaemia Cytogenetics (Referral Service) (page 2 of 4)
tests from working
time of days)
venesection
Cytogenetic FISH (Fluorescent As above Poor sample Analysis will be carried as No N/A 10 working
Insitu Hybridisation) Analysis quality (clotted appropriate or in consultation with service days for
-Testing for suspected Bone Marrow or or more than a the referring Consultant or provided diagnostic
haematological disease disorders Peripheral Blood day old) Registrar. AML, ALL
(at presentation, post therapy or in EDTA for FISH and CML’s
bone marrow transplant). only. Sample Transport to laboratory as soon
transported as possible before 1630hrs. 15 working
CD138+ isolated days for all
Aplastic anaemia plasma cells for and or stored
AML-M1,M2,M3,M4,M4Eo,M5 above or below The samples may be left other routine
FISH on multiple overnight at room temperature tests.
A.L.L myeloma cases is room
Burkitt’s Lymphoma temperature and delivered to laboratory
preferable immediately the following
CLL
however bone morning.
CML Sample
Diffuse Large B cell Lymphoma marrow samples
may also be Contaminated
ET by bacteria
Follicular Lymphoma adequate.
Hypereosinophilic Syndrome
Sample taken
Mantle cell lymphoma
MDS
into wrong
Multiple Myeloma transport
MPD (ITP/Polycythaemia) medium
NHL
Plasma cell Leukaemia
PRV

Leukaemia Cytogenetics (Referral Service) (page 3 of 4)
tests from working
time of days)
venesection
PCR Peripheral Blood Sent to Dr Jaspal Kaeda No N/A 10 working
- BCR/ABL in 10-20ml EDTA Hammersmith Hospital service days
- Ph+ve ALL provided
Samples will be sent the following
day if received after 3pm.
Samples need to arrive before
midday on Fridays and prior to
bank holidays which span a
weekend
• Chimerism Studies Peripheral Sent to Steve Hart/Adele, Fielding No N/A 10 working
• JAK-2 mutation analysis Blood/Bone Royal Free Hospital. service days
• T-cell receptor Marrow in EDTA provided
rearrangement
weekend
CLL Peripheral Sent to HMDS, No N/A 10 working

• MRD Blood/Bone St James Hospital service days
• IgVH Marrow in EDTA Samples will be sent the following provided
weekend

Leukaemia Cytogenetics (page 4 of 4)
tests from working
time of days)
venesection
PDGFR receptor Peripheral Sent to Professor Nick Cross, No N/A 10 working
Blood/Bone Salisbury District Hospital service days
Marrow in EDTA provided

weekend
Referral laboratories:
Leukaemia Unit Molecular Diagnostics Laboratory HMDS Wessex Regional Genetics Lab
Department of Haematology Department of Haematology Bexley Wing Salisbury District Hospital
Hammersmith Hospital Royal Free Hospital St James Hospital Salisbury
Ducane Rd Pond St, Hampstead Beckett Street Wiltshire
London W12 0NN London NW3 2OG Leeds LS79TF SP2 8BJ
Paediatric Clinical Cytogenetics

Level 2
Camelia Botnar Laboratories
Great Ormand Street
London WC1N 3JH


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University College London Hospitals

NHS Foundation Trust

HAEMATOLOGY AND BLOOD TRANSFUSION

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 2 of 36

Routine Laboratory Working Hours and Contact Numbers

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 3 of 36

Departmental Lead: Pamela Carr 0203 447 8545 or x78545

Departmental Lead: Norma McQueen

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 4 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 5 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 6 of 36

SST Anti Cardiolipin antibodies (Antiphospholipid antibodies)

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 7 of 36

Inpatient Services Outpatient Services

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 8 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 9 of 36

Special Handling Requirements

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 10 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 11 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 12 of 36

Referral Laboratory (Malaria testing)

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 13 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 14 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 15 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 16 of 36

For further Information refer to the Trust Major Haemorrhage Protocol

2. Non-acute bleeding and neonatal surgery

Obtain: Coagulation screen and FBC

Monday →Friday 09:00-17:00: All other times:

Discuss: Appropriate treatment

4. Patients with Special Transfusion Requirements

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 17 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 18 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 19 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 20 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 21 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 22 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 23 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 24 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 25 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 26 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 27 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 28 of 36

Flow Cytometry Laboratory (HIV and Cell Markers) (page 2 of 4)

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 29 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 30 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 31 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 32 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 33 of 36

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 34 of 36

CLL Peripheral Sent to HMDS, No N/A 10 working

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 35 of 36

Samples will be sent the following

Paediatric Clinical Cytogenetics

HAEM-PD-UserHbook V6 Haematology and Blood Transfusion User Handbook Page 36 of 36

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