Events in 2023

Following on from a talk given last year on the Precision AMR Project, this presentation will look at the incorporation of WGS and genotypic methods vs phenotypic methods and how they can impact on diagnostic laboratory practices, antibiotic reporting and prescribing.

This presentation follows on from the research on the Precision AMR project and discusses how this can be translated into routine practice. Also looking at potential new workflows that may be incorporated into laboratory's to support clinicians and infection control.

Transplant Assessment and Relative Opportunity Tool (TAROT) for Renal Transplantation: Improving the chance of transplant for immunologically complex patients

This session provides an overview of the key changes to the ISO 15189 standard and explains the UKAS transition process including deadlines and actions to be taken by accredited organisations.

The same session is being run on Monday, Tuesday and Thursday to ensure as many delegates as possible are able to attend.

Highlights from the 2022 Annual SHOT Report: lessons learnt and learning from excellence

Quality issues and accreditation for andrology services

Delegates attending this session will learn about and gain knowledge on the introduction and application of the new EQA scheme to cover digital pathology in Cellular Pathology.

EQA: What’s happening?

The idea of generating blood cells in vitro for transfusion is not new but only now we are reaching the point where the concept is reaching clinical trials. In vitro derived blood cells (namely platelets and red cells at this stage) are complementary to blood donor-derived products but with distinct advantages: biological safety, more resilient supply line and potentially less immunogenicity.

We have developed a forward programming approach relying on the overexpression of transcription factors in pluripotent stem cells to produce the platelet mother cells, the megakaryocytes, conferring added efficiency and purity to the culture system. The challenges that remain to be addressed are related to transition to GMP production, optimising platelet release in the culture and quality control of the final product. The power of genome editing has also allowed us to explore the production of platelets with added clinical benefit (immune silent, added thrombotic potential).

Red cell production from primary CD34+ progenitors has been demonstrated in academic laboratories about a decade ago. We are now mid-way through a first in human study to look at the potential of using in vitro derived red cells for transfusion. One of the main benefits would be a potentially longer survival of the manufactured red cells in the circulation than their donor-derived counterpart. This would allow spacing out transfusion intervals for patients on chronic transfusion programme, thereby reducing iron overload.

Thrombophilia is defined as hereditary and/or acquired conditions associated with an increased predisposition to thrombosis. The previous British Society for Haematology guideline on thrombophilia testing (2012) focused only heritable thrombophilia testing. The updated guideline published in 2022 (1) has a widened scope to include both heritable and acquired thrombophilia especially antiphospholipid antibodies, paroxysmal nocturnal haemoglobinuria, myeloproliferative neoplasm (MPN) and the presence of a JAK2 mutation in the absence of an MPN phenotype. Disorders such as cancer, inflammatory conditions and obesity are associated with thrombosis through multiple mechanisms, but these are not included in the guideline which focuses only the factors identified from laboratory testing.

The key principle in the guideline is that when clinical utility of testing is not clear, thrombophilia testing is not mandatory, and testing should be done only if the result will alter the management of the patient. These guidelines emphasise the importance of identifying antiphospholipid syndrome and JAK2 +/- MPN phenotype because they have a significant impact on management. The guidelines confirm the limited utility of testing for hereditary thrombophilia testing in venous thromboembolism, arterial thrombosis and recurrent pregnancy loss.

1. Arachchillage, DJ, Mackillop, L, Chandratheva, A, Motawani, J, MacCallum, P, Laffan, M. Thrombophilia testing: A British Society for Haematology guideline. Br J Haematol. 2022; 198: 443– 458. https://doi.org/10.1111/bjh.18239

The aim of this presentation is to explain the growing importance of the use of cytopathology cell blocks in the diagnostic process and how this has evolved over recent years. In the past they were used as an 'extra' to the traditional Papanicolaou and Romanowsky stains whereas now they have an essential role in providing material for ancillary testing - immunocytochemistry and molecular studies.

The variety of methods of cell block preparation will be covered and why it is important that a department choses what method, or methods, are best suited to what is required from the finished result.