The haemostasis laboratory is located in the Haemophilia Centre at the Kent and Canterbury Hospital provides a comprehensive clinical and laboratory service for the diagnosis, treatment and management of all bleeding or thrombotic diseases.
The team includes consultant haematologists, biomedical scientists and support staff who undertake a range of routine and specialised investigations. They work alongside a larger multidisciplinary team consisting of nursing, physiotherapy and administrative staff, all based within the Haemophilia Centre to ensure each patient requires the support they need.
The Haemophilia Centre is a UKAS accredited service to standard ISO 15189:2012 (see scope of accreditation below).
All tests not listed on this scope are not accredited to ISO 15189:2012 but are within the governance of the quality management system.
Investigating bleeding disorders
These investigations are undertaken if there is a clinical history of excess blood loss for whatever the reason (for example, post operation or during menstruation). There are numerous reasons that cause excess bleeding. By establishing this, it is far easier to minimise any future risk that may arise.
Monitoring of anticoagulant therapies
These investigations are performed to monitor many different types of drugs, both taken orally or as an injection. These drugs are important to reduce the risk of clots forming inappropriately, however, it is a fine balance, given in excess they will cause bleeding. Hence for some drugs they need to be monitored regularly.
The most common drugs we monitor regularly are vitamin K antagonists. Warfarin is by far the most used in this medicine group. Monitoring is performed by sampling blood from a finger tip (capillary) or from the arm (venous). Capillary clinics are established at a number of hospitals and are by appointment only. Monitoring is also performed in some GP practices and some high street pharmacies by appointment. Patients must always carry their record book with them.
Sometimes it is necessary to take heparin by injection. Low molecular weight heparin is an immediate acting anticoagulant which for most people does not need monitoring routinely.
There are now many new drugs available for specific clinical conditions that do not routinely need laboratory monitoring to ensure they are working. However, the laboratory can undertake assays to detect drug activity if required.
Investigation of thrombotic disorders
These investigations are performed to establish whether there is a biological cause for thrombosis. Venous thromboembolism (VTE) is the commonest cause of preventable death in patients being admitted to hospital. There are many different tests that are performed to establish whether there is a risk to the individual. Risk may be due to a defect in the blood, (either hereditary or acquired) or may be from an environmental factor.
The laboratory offers a comprehensive diagnostic service, using a range of specialist equipment and knowledge. This enables us to detect and treat rare bleeding and thrombotic diseases and both a cellular and molecular level.
These investigations are used to detect defects in an individual person’s genes which is then used to confirm a disease diagnosis. DNA from an individual is broken down to look for the gene abnormality. These methods are highly sensitive and accurate. Based on the findings, medical staff can then advise families for screening where appropriate if other individuals are at risk.
For the diagnosis of haemophilia, it is extremely important to offer genetic counselling and support for families.
For the diagnosis of thrombotic disorders, genetic analysis is only offered to individuals over 16 years old. This can be discussed with a consultant haematologist.