UCLH is a national referral centre for Andrology with adult and paediatric patients being referred acutely for management of their priapism. It is also a centre for the reconstructive and implant surgery often needed for this disorder. The Andrology team works very closely with the Red Cell Unit to manage their acute episodes and optimise patients for their surgery. Patients with haemoglobinopathies will come under joint care and for planned procedures will need to have an outpatient appointment with the Red Cell Team .
Referrals to Andrology should be sent to Mr
David Ralph and Mr Suks Minhas.
- special status as a blood establishment.
- round the clock cover for transfusion with blood being delivered several times a day from the Colindale Blood transfusion centre.
- fully CPA accredited ( described as outstanding during a recent MHRA inspection.)
dedicated Specialist Practitioner of Transfusion (SPOT) who acts as the laboratory clinical interface for haemoglobinopathies. Specially phenotyped blood is sourced by the department for the haemoglobinopathy patients.
The genetics laboratory is recognised by the thalassaemia international federation (TIF) as well as by ENERCA as reference laboratory for investigation of thalassaemia and rare anaemias.
- one of only 3 laboratories in the UK.
- provides genetic characterisation of haemoglobin types, with a referral pattern from North London as well as more widely.
- provides expertise for timely risk assessment for couples where both partners carry a haemoglobinopathy gene.
- Tests on pregnant mothers, including chrorionic villus sampling, are turned around within a week.
The ability to perform all of this as an integrated service is critical to minimising late abortion in affected pregnancies. Referrals for an appointment at the antenatal clinic for at risk women can be made to
Dr Mary Petrou. Samples can also be sent from red cell patients using the haemoglobinopathy genetics form after discussion with one of the consultant haematologists in the red cell team.
Tests currently available include: GAP PCR and restriction enzyme digests for alpha mutations, Restriction enzyme PCR for beta and delta thalassaemia, Hb Variants, Haemochromatosis, RFLPs and Xmn polymorphism, ARMS for beta thalassaemia and Hb variants, GAP PCR for beta thalassaemia, Hb Lepore,STRs, HPFH and delta beta thalassaemia, SSM for beta thalassaemia and HbC, DNA sequencing for alpha and beta genes, MLPA for alpha and beta genes.
- offers a variety of tests crucial in the management of sickle cell disease including HPLC and gel electrophoresis.
- expertise and capacity for the investigation of rare haemolytic anaemias that often require a range of tests.
Rare cases of suspected thalassemia without an identified mutation may require globin chain synthesis as well as presumptive diagnosis of alpha thalassaemia carrier state. Any request other than HPLC or sickle cell screen needs to be discussed with a consultant in the red cell team,as these tests may need special conditions and staffing.
Tests currently available include: Sickle cell screen, Haemoglobinopathy Screening (HPLC), Cellulose Acetate Electrophoresis (pH 8.6 Acid Gel Electrophoresis) Globin Chain Electrophoresis, HbA2 Electrophoresis and Elution, G6PD Assay, PK Assay, Hb H Staining, Oxygen Dissociation, Heinz Body Staining, Red Cell Osmotic Fragility, EMA Assay (for Hereditary Spherocytosis), Methaemoglobin Screen, Isopropanol Precipitation and Heat Stability (unstable Haemoglobins) and Globin Chain Biosynthesis.