Our H&I laboratory

Our Histocompatibility and Immunogenetics (H&I) lab provides diagnostic and reference services, including:

• human leukocyte antigens (HLA) testing to support transplantation
• provision of HLA and human platelet antigen (HPA) selected platelets for refractory patients
• investigation of fetal neonatal alloimmune thrombocytopenia (FNAIT), post-transfusion purpura (PTP) and transfusion reactions
• HLA testing for disease diagnosis and pharmacogenetics

Our H&I services are provided by our lab at the Royal Infirmary of Edinburgh.

Our lab details

• Telephone: 0131 242 7528
• Email: NSS.handi@nhs.scot

Key contacts

Consultant Clinical Scientists (H&I)

Dr David Turner

• Telephone: 0131 242 7534
• Email: david.turner@nhs.scot

Dr Richard Battle

• Telephone: 0131 242 7526
• Email: richard.battle@nhs.scot

Consultant Haematologists

Dr Lynn Manson

• Telephone: 0131 242 7527
• Email: lynn.manson@nhs.scot

Dr Jennifer Easterbrook

• Telephone: 0131 242 3185
• Email: jennifer.easterbrook@nhs.scot

H&I Laboratory Manager

Sylvia McConnell

• Telephone: 0131 242 5140
• Email: sylvia.mcconnell@nhs.scot

Out of hours

A clinical scientist is always available for clinical advice relating to any results generated within our H&I lab.

There is an on-call healthcare scientist for solid organ transplant related work. The transplant co-ordinator or clinical scientist should initiate call out.

Reporting times

Our targets for reporting results are:

• HLA type: 2 weeks
• HLA antibody screening: 2 weeks 
• Post transplant antibody monitoring: 2 days
• HLA type of local donor: 4 hours
• Crossmatch result (cadaver donor): 4 hours
• Crossmatch result (living renal donor): 1 week
• Disease association testing: 2 weeks
• Platelet testing: 2 days
• CD34+ enumeration: less than 2 hours
• MAIPA & HNA testing (tested by NHSBTS Bristol)

You should discuss any urgent requests with the lab, particularly post transplant antibody monitoring samples.

Sample factors influencing test performance and results

Haemolysed samples may influence test results and receipt of a haemolysed sample may result in the request for a replacement.

All serological tests require fresh samples that have been bled in the last 48 hours.

Certain immunosuppressive agents may influence the tests undertaken in H&I, these include:

• ATG
• IVIg
• monoclonal antibodies therapies including rituximab

If patients are known to be receiving these agents this should be highlighted to the laboratory on the request form.

DNA typing of haematology patients may prove difficult if the patient is pancytopenic and therefore efforts should be made to HLA type patients early in their treatment.

Accreditation

Our Edinburgh H&I lab is accredited through the United Kingdom Accreditation Service (UKAS) and the European Federation for Immunogenetics (EFI). Copies of our accreditation certificates are available on request.

Please note that accreditation for HLA typing by Next Generation Sequencing is pending following submission of Extension to Scope documentation to UKAS.

Quality assurance

Our quality management system monitors and audits all aspects of our service. All laboratory investigations and clerical procedures are governed and maintained by compliance with the SNBTS Quality Manual, management procedures and relevant standard operating procedures (SOPs).

Standards of testing are maintained by the rigorous use of internal quality assurance protocols and through participation in appropriate external quality assessment schemes (UK NEQAS).

Quality assessment and external Audit

A copy of last year’s participation certificate and results summary is available on request for:

• UK NEQAS for Histocompatibility and Immunogenetics
• UK NEQAS for Leucocyte Immunophenotyping (for CD34+ enumeration testing)

Complaints, comments and suggestions

As a strategic business unit (SBU) of NHS National Services Scotland (NSS), we are committed to capturing and recording feedback from service users and reviewing this correspondence as part of the NSS continual improvement programme.

If you are dissatisfied with any aspect of the service you have received, get in touch with any of our contacts.

Protection of personal information

In line with NSS information security policies, our lab has information technological and organisational safeguards in place.

These help us ensure that the confidentiality, integrity and availability of all forms of information held on patients, donors, NHSScotland staff and family health contractors, are not lost or compromised.