Specialised Laboratory User Guide (PDF 777Kb)
The Specialised Laboratory Medicine Delivery Unit is comprised of the Purine Research Laboratory, Metabolic Laboratory including the south east newborn screening service, Medical Toxicology and Specialised Chemistry laboratories.
Some of our laboratories are world renown for their work and located on the fully refurbished state of the art laboratories on the St Thomas’ Hospital site.
Investing in the future through training and development is central to the provision of the specialised national referral services offered by SLM. The Paediatric Metabolic Biochemistry Laboratory is a regional training centre for trainee Clinical Biochemists, accommodating 5 or 6 trainees per year on a one month rotation. Trainee Clinical Biochemists based within Pathology receive a minimum of three months training in this area. We aim, in the future, to extend training in this specialised area to trainee Biomedical Scientists.
The Metabolic Biochemistry Laboratories at Guy’s & St Thomas’ offer a comprehensive service for the diagnosis and screening of inherited metabolic diseases nationally and internationally.
We have strong links with the metabolic clinical team and other laboratories within the Trust including Biochemical Genetics and the Purine Research Laboratories.
We offer a comprehensive test repertoire for patients suspected or presenting with inherited metabolic diseases, including amino acid, organic acid and very long chain fatty acids analysis. The laboratory is staffed with highly qualified and motivated scientists.
The Newborn screening laboratories screen approximately 60,000 live births for Phenylketonuria (PKU) and Medium Chain Acyl Co-A Dehydrogenase Deficiency (MCADD) and screening for Congenital Hypothyroidism (CHT), Cystic Fibrosis (CF) and Sickle Cell Anaemia & Thalassaemia are soon to be moved to the St Thomas’ Laboratory.
Technology for analysis includes state of the art tandem mass spectrophotometers and HPLC.
Purine Research Laboratory provides a highly specialised service for purines and pyrimidines metabolism and related disorders. Laboratory diagnosis offered is mainly based on enzyme activity, presence of abnormal metabolites in body fluids, abnormal clearance of endogenous metabolites and mutation analysis.
Research and development underpins the specialised service. R&D in the areas of inherited metabolic diseases and pharmacogenetics provides opportunities for post graduate study for both laboratory staff and our colleagues in clinical departments. R&D initiated by the Purine Research Laboratory has in the past few years led to the award of two PhD degrees to members of staff. R&D collaborations between the Purine Research Laboratory and clinical departments currently support post graduate study for clinician researchers at both MD and PhD level.
Specialised Chemistry laboratories include Endocrine, Immunochemistry (proteins) and Immunosuppressants Sections.
The Endocrine section offers unique assays which are either available in this Centre only or in no more than two other SAS Centres. The Endocrine laboratory has been successful over the years in attracting several research grants for immunoassay development as well as for collaborative projects with other departments and clinicians/endocrinologists and has contributed to many original research publications. The unit is an important and busy section for training and has been instrumental in supervising many students, trainee Clinical Scientists, Biomedical Scientists, Specialist Registrars and ensuring the completion and submission of research projects (PhD theses, MSc Projects, BSc projects). Current projects include development of sensitive LC-MS/MS assays for the simultaneous measurement of steroids, and biogenic amines using online-SPE.
Guy’s and St Thomas’ Cancer Centre is part of South East London Cancer Network and immunochemistry (proteins) section provide services to haemato-oncology team as well as offering assays to other hospitals. The section is equipped with automated Capillary Electrophoresis, agarose gel electrophoresis systems and nephelometer. Monoclonal proteins are characterized by immunotyping and/or immunofixation. Test repertoire also includes serum free light chains, cryoglobulins, cholinesterase phenotyping, stone analysis and CSF Xanthochromia scanning. Staff also has close links with myeloma multidisciplinary team. Section also supports MSc projects in the training of Clinical and Biomedical Scientists.
The Immunosupressants service includes Cyclosporin, Tacrolimus, Sirolimus and Mycophenolic acid analysis using LC-MS/MS. It is a very busy section and provides analyses mainly for Transplant Clinics in the Trust as well as external hospitals. The section has a capacity for high throughput and offer same day Cyclosporin, Tacrolimus and Sirolimus results during routine working hours.
Toxicological analyses can play an important part in the diagnosis, prognosis and treatment of poisoning and in the monitoring of drug therapy and abuse. The Medical Toxicology Laboratory (previously the Poisons Unit) has taken a leading role in these investigations since its inception in 1967.
The Laboratory primarily supports services for (i) the clinical diagnosis and management of acute or chronic poisoning, and occupational or environmental exposure to chemicals, (ii) Monitoring drug therapy and (iii) the treatment of drug and substance abuse.
The laboratory also provides services for pharmaceutical companies and coroners.
The Clinical & Forensic toxicology section uses immunoassay, gas- and liquid-chromatography, and spectrophotometry techniques to test for over 500 pharmaceutical and illicit drugs, and some other commonly ingested poisons in both clinical and forensic specimens. Gas Chromatography Mass Spectrometry is used as part of our routine screening services.
The Therapeutic Drug Monitoring section aids in optimising treatment by ensuring adequate dosage and minimising the risk of toxicity. Selective chromatographic assays for a range of drugs are available. Use of such analyses should be considered when there is a need to establish baseline values during successful therapy, if a patient is refractory to treatment because of non-compliance, inadequate dosage or resistance to the drug used, if toxicity is suspected or when modifying dosage or concomitant therapy where drug interactions are possible.
The Drugs of Abuse Screening laboratory is a major service provider to drug clinics, hospitals, general practitioners and rehabilitation centres. Screening is essential for proper monitoring of treatment of drug abuse, enabling drug abuse treatment clinics to check that patients are taking their methadone or buprenorphine medication as prescribed, but are abstaining from other drugs. Information provided by the service can also help in the assessment of patients with no overt history of drug abuse, and is also used by doctors to check that patients suspected of drug abuse are drug- free before receiving treatment.
The services of the three laboratories are provided by a team of experienced analysts and support staff. R&D allows method development to allow new and supplemental compounds to be introduced into our repertoire.
To support the work of our laboratory scientists we have a dedicated team to manage training and development and Quality and Governance.
Team Profiles
Joanne Clapton
Acting DU Manager
Specialised Laboratory Medicine
