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Transfusion Medicine and Immunohematology

The Department of Transfusion Medicine and Immunohaematology (earlier known as ‘Clinical Pathology and Blood Bank’) has four main areas – the blood bank, and the ‘IP’, special test and HLA laboratories.
The John F. Scudder memorial blood bank bleeds more than 20,000 donors per year. 90% of its collection is processed into blood components. Our blood bank has been a leader in instituting technological advances that increase the safety of transfusion, such as column based grouping and compatibility testing, antibody screening using phenotyped cell panels and nucleic acid (NAT) testing for HIV, HCV and Hepatitis B.
People live when people give               
The IP lab provides blood counts, urine investigations, counts on CSF and other body fluids, microscopic reporting of blood and bone marrow smears, and various other tests. More than two thousand blood samples are processed here each day. 
The special test laboratory performs holistic diagnostics for bleeding and thrombotic disorders and haemolytic anaemias. It is a reputed referral centre within the country for the diagnosis of bleeding disorders. 
The HLA lab performs HLA typing and antibody screening for transplantation purposes and the diagnosis of HLA associated diseases. It is among the few tissues typing laboratories in the country to use Luminex technology which enables high throughput typing and antibody screening at the highest level of detection. 
The department also manages blood collection in the OPD and at specific times in the wards. Over three thousand blood samples are collected each day and sent to various laboratories within the hospital for testing. To maintain its various services, the department employs more than two hundred people, making it the second largest employer within CMC.
Beyond excellence in service, we strive to make a national impact in the fields of transfusion medicine, laboratory haematology and immunogenetics through educational and research activities.
The department runs three courses, two EQAS programs, trains students and observers from India and abroad, and conducts CMEs and conferences. Our goal is not merely education, but the generation of policies and consensus as regards standards in practice.

The department of Transfusion Medicine and Immunohaematology runs the blood bank, four laboratories – IP, immunohematology, special test and HLA, and sample collection facilities.
Blood bank
The John F. Scudder memorial blood bank is situated next to the Chapel of Hope on the ground floor of the main building. It functions for 24 hours, 7 days a week.
Blood donation and camps
Donors are welcome to donate at any hour during the day or night. However, in conformance with licensing rules to minimize the risk of transfusion transmissible illnesses, only unpaid, non-professional donors are accepted. This includes relatives or friends donating to replace the units used by patients known to them, or voluntary donors donating to the bank. Patients, if physically fit, also have the option of autologous donation prior to elective surgeries. All donors are screened to ensure that they are physically fit to donate, as well as to minimize the possibility of transfusion transmissible illnesses.
To maximize voluntary blood donation, the blood bank conducts blood donation camps supported by colleges and other organizations in and outside Vellore. (If you would like to help organize a blood donation camp in your community or organization in or near Vellore, contact our Public Relations Officers at  9367985489 or 9367985490.)
Blood testing in the blood bank
A variety of tests are performed in the blood bank to ensure, as far as is possible, the safety of each transfusion. 
Compatibility testing (immunohaematology)
Compatibility testing, involving blood grouping, screening for irregular red cell antibodies and crossmatching, is performed to minimize the chance of occurrence of haemolytic transfusion reactions. These tests are performed using more than one technique with a high degree of sensitivity, such as column agglutination technology (CAT). Records of patient grouping and other relevant details are saved for future referral.
Infectious disease screening
All donor blood units are tested for HIV, hepatitis B, hepatitis C, malaria and filaria. Nucleic acid testing (NAT), which is the most sensitive methodology available, as well as  a fourth generation ELISA platform, are used to screen for HIV, hepatitis B and hepatitis C. 
Blood components
More than 90% of the blood collected in the blood bank is processed into components. This allows one donation to benefit multiple patients and also maximizes the efficacy of transfusion. 
Blood components are prepared by separating the individual components of blood i.e. red cells, plasma or platelets and storing these under conditions that optimize their effectiveness while reducing undesirable effects due to unwanted components. Components can be further modified (eg. leukodepleted or irradiated products) to make them safer. 
Red cell components
Whole blood is rarely indicated in modern transfusion medicine. Therefore very few units are retained as whole blood. While some units are converted into packed cells (PC) majority are converted into red cells in an additive solution, (RC) that results in superior preservation, and provides a smoother and faster flow than packed cells while effectively removing plasma. Red cells under routine storage conditions can only be preserved for 35 days.
Plasma components
Plasma products available include fresh frozen plasma (FFP), cryoprecipitate, cryosupernatant and bank plasma. The first three, prepared within a few hours after collection and stored frozen, contain plasma factors involved in coagulation. 
Fresh frozen plasma contains most coagulation factors, while cryoprecipitate is selectively rich in Factors VIII, XIII, von Willebrand factor and fibrinogen. Cryosupernatant contains the other coagulation factors retained in plasma after production of  cryoprecipitate. Bank plasma which is stored at 4 degrees Celsius may be used to replace albumin in patients with low levels. 
Platelet rich concentrate (PRC)
Platelet rich concentrates are used in patients with low platelet counts, to prevent or contain bleeding. They are either prepared from whole blood (called Random Donor Platelets or RDPs) or by platelet pheresis (called Single Donor Platelets or SDPs). SDPs give a larger platelet quantity (equivalent to 4-6 RDPs) at a single donation, and allow for increased frequency of platelet collections (upto twice a week) from a single donor. This is useful in patients who require prolonged or large doses of platelet transfusions, as with chemotherapy for malignancies or marrow failure. In such patients use of SDPs helps to minimize the number of donors the patient is exposed to, which in turn reduces the risks of transfusion transmitted infections, allosensitisation and platelet refractoriness. SDPs also carry the additional advantage of being leukodepleted. We store platelets for only 3 days.
Irradiated products
Transfusion of cellular products i.e. red cells and platelets, in severely immunocopromised patients such as following marrow ablation, or in preterm infants or foetuses can produce a life threatening immunological reaction where donor immune cells attack the recipients tissues, called graft versus host disease. Irradiation of the transfused unit prevents this by inactivating white blood cells. Irradiation is performed at the request of the clinical firm, which must specify this requirement in the requisition.
Leukodepleted products 
Leukodepleted products are ones where white blood cells have been removed.  These minimize the risks of antibody formation to white blood cell antigens like HLA, and of certain infections carried by the white cells such as cytomegalovirus (CMV). They are particularly useful in patients who require multiple platelet transfusions, and in patients who are to undergo transplants, where anti HLA antibodies can be harmful. They also can help to avoid fever during transfusions, a common adverse reaction. 
The need for a leukodepleted product must be specified by the clinician in the request for blood.
Pheresis
Pheresis is a procedure where blood is drawn into a machine that selectively removes a particular component and reintroduces the remainder of the blood into the body. This procedure is used in our blood bank for the collection of platelets (SDPs). As compared to whole blood donation it offers the advantage of allowing more frequent collections from a donor. However, each collection takes more time (upto two hours) and carries a slight risk of some adverse effects to the donor related to exposure to the anticoagulant solution. Platelet pheresis is performed when indicated at the request of firm doctors, and is generally a directed donation by relatives for the benefit of their patient.
EQAS
The blood bank conducts an EQAS program for immunohematology. For more information or to enroll contact us at clinpath@cmcvellore.ac.in
Laboratory services
IP lab 
The ‘IP’ lab is located on the 5th floor of ASHA building. The term ‘IP’ is a misnomer as it processes both inpatient and outpatient samples. It receives blood, urine, body fluids and marrow aspirate smears for cell counts and morphological assessments. The tests performed in the laboratory are mentioned in section 3.2.4
Special test lab
The special test laboratory is situated on the 5th floor of ASHA building. It is involved with tests used to evaluate haemostasis and to diagnose haemolytic disorders. The tests performed here are mentioned in section 3.2.4
Diagnostic packages for coagulation, thrombosis and haemolytic disorders comprising multiple relevant tests are available. This requires referral by a clinician who suspects such a condition. Extra institutional referrals are also accepted. (see section 4.1.1)
As the patient’s clinical history contributes significantly to the diagnosis, and the manner of sample collection can affect test results, the patient (unless immobile) is required to be personally present at the special test lab.
Workups are accepted only on weekdays before 12 p.m. unless it is an emergency. Ideally, the patient should be fasting (this rule is relaxed for infants). Usually the result for the coagulation workup is available on the same day by evening, for thrombotic workup within two weeks, and haemolytic workup within a few days. However some tests may take longer. 
EQAS
The special test laboratory conducts an EQAS program for coagulation. For more information about this contact us at clinpath@cmcvellore.ac.in
HLA laboratory
The HLA laboratory is situated on the ground floor of the main building opposite the blood bank. The laboratory performs HLA typing and antibody screening supporting the institution’s bone marrow and renal transplant programs. Samples from outside CMC are also accepted upon referral by consultation (see section 4.1.1). Samples are also sent for screening for HLA antigens associated with diseases eg. HLA B27 associated with ankylosing spondylitis. 
Typing is done by molecular methods. Antibody screening platforms available are complement dependent cytotoxicity (CDC), enhanced CDC, ELISA and Luminex. (For the list of tests available, see section 3.2.4) 
Blood samples for HLA tests are collected within the HLA lab itself. The CDC test requires a prior appointment. A clinician’s request is mandatory for all HLA tests to be performed, and the report may be accessed only through the clinician.

Laboratory tests available

 

Investigation

Primary sample

Method(s)

Indication

Performed in

Red cell Antibody titration

EDTA blood

Tube agglutination.

To know the titre/amount of red cell antibody, which is used to make clinical decisions eg. in haemolytic disease of the newborn where level of maternal antibodies against the foetus red cells are titrated to decide the need for intervention.

Blood bank

Direct Coombs Test (DCT)

EDTA blood

Tube agglutination, CAT

To know whether a persons red cells are coated with antibodies eg. for detection of transfusion reactions, haemolytic disease of the newborn, etc.

Blood bank

Indirect Coombs Test (ICT)

EDTA blood

Tube agglutination, CAT

To detect anti red cell antibodies in blood.

Blood bank

Antibody screening using red cell panel

EDTA blood

Tube agglutination, CAT

To detect clinically significant anti red cell antibodies in blood. Performed for all patients requiring transfusion and blood donors as part of compatibility testing. Also performed in pregnant women to help detection and management of foeto maternal incompatibility.

Blood bank

Cross match

EDTA blood

Tube agglutination,CAT (saline/ LISS/ 37 degrees/ 4 degrees/Coombs)

To know whether donor and recipient blood are compatible. Performed prior to every red cell and plasma transfusion

Blood bank

Extended pheno typing

EDTA blood

CAT and tube agglutination

To identify the antigens present on red cells. Useful in patients with red cell antibodies.

Blood bank

Antibody identification.

EDTA blood

CAT

To identify red cell antibodies in a patients serum

Blood bank

Red cell genotyping

EDTA blood

CAT

To identify group or Rh type from the patient’s <st1:stockticker w:st=”on”>DNA. Useful where grouping or Rh typing using red cells is controversial or difficult.

Blood bank

Bone marrow double esterase

Bone marrow

Cytochemical stain

To identify cells of neutrophilic/monocytic lineage eg. in AML M4/5

IP lab

TRAP stain

Bone marrow

Tartarate resistant acid phospatase stain

To diagnose hairy cell leukaemia

IP lab

ANAE stain

Bone marrow/EDTA blood

Alpha Naphthol Acetate Esterase staining

To identify cells of monocytic lineage eg. AML M4/5, and also for AML M7

IP lab

PAS

Bone marrow/EDTA blood

Cytochemical stain

To help identify lineage eg. ALL, AML M6

IP lab

<st1:stockticker w:st=”on”>SBB

Bone marrow/EDTA blood

Cytochemical stain

To identify myeloid lineage eg. AML

IP lab

Absolute Eosinophil count

EDTA blood

Derived parameter on automated cell counter

To detect deviations in eosinophile count. An increase may suggest allergic reactions, parasitic infestations, etc.

IP lab

ESR

EDTA blood

Micro centrifugation method

Nonspecifically helps in diagnosis and follow up of conditions like rheumatoid arthritis, tuberculosis, myeloma, etc.

IP lab

Haemoglobin

EDTA blood

Measured parameter on automated cell counter

To diagnose anaemia (decreased haemoglobin) or polycythemia (increased haemoglobin)

IP lab

Mean Corpuscular Haemoglobin (MCH)

EDTA blood

Calculated parameter on automated cell counter

Helps to detect and characterize anaemia depending on the haemoglobin content of RBCs.

IP lab

Mean Corpuscular Haemoglobin Concentration (MCHC).

EDTA blood

Calculated parameter on automated cell counter

Helps to characterize anaemia based on haemoglobin concentration within RBCs

IP lab

Mean Corpuscular volume

EDTA blood

Derived parameter on automated cell counter.

Helps to characterize anaemia depending on the size of RBCs. Eg, iron deficiency anaemia has small (microcytic) cells while anaemia due to Vitamin B12 deficiency has large (macrocytic) cells

IP lab

Mean Platelet Volume (MPV)

EDTA blood

Derived parameter on automated cell counter

Helps to detect specific conditions with large or small platelets. Also where large platelets are present, may indicate the need for smear checking for inaccuracy in the automated platelet count

IP lab

PCV

EDTA blood

Calculated parameter on automated cell counter, microhaematocrit

To diagnose anaemia

IP lab

Peripheral blood smear examination

EDTA blood

Manual microscopy on Romanowsky stained smear

To diagnose haematological or other conditions that manifest with changes in peripheral blood cell counts and morphology or other abnormal smear findings eg. leukaemias, anaemias like iron deficiency and some haemolytic anaemias, etc.

IP lab

Platelet count

EDTA blood

Derived parameter on automated cell counter,

Manual, estimate from smear

To detect deviations in the platelet count that put the patient at risk of bleeding or thrombosis and to help in diagnosis of conditions that may manifest as such deviations

IP lab

RBC count

EDTA blood

Measured parameter on automated cell counter

Useful to diagnose and characterize anaemia.

IP lab

Red cell distribution width (CV %)

EDTA blood

Derived parameter on automated cell counter

A measure of variation in red cell size, detecting events that lead to such variation eg. transfusion, treatment

IP lab

Reticulocyte count

EDTA blood

Automated cell counter, manual

Useful in anaemia as it reflects marrow regenerative capacity. Raised in haemolytic anaemias, low in marrow aplasia

IP lab

WBC differential

EDTA blood

Automated cell counter, manual

To detect variations in distribution of white cells which may occur in various diseases and to follow up the same

IP lab

WBC Total

EDTA blood

Measured parameter on automated cell counter

To detect variations in count of white cells which may occur in various diseases and to follow up the same

IP lab

CDC crossmatch (routine and extended incubation)

Citrated blood

Microlymphocytotoxicity

To detect antibodies in prospective transplant recipients against donor HLA antigens, particularly prior to renal transplants. Such antibodies can be deleterious to the graft.

HLA lab

DTT cross match

Citrated blood

Micro lymphocytotoxicity

A variation of CDC that uses Dithiotreitol to differentiate IgM from IgG antibodies as the two have differing significance.

HLA lab

HLA typing –A, B, C, DRB1, DQB1

Citrated blood

Molecular low resolution – Luminex SSOP, SSP

To characterize HLA antigens. Performed prior to transplant to assess compatibility or matching of antigens between donor and prospective recipients. A lower degree of matching can lead to more complications.

Typing for specific loci can also be done in the context of disease associations eg. tropical sprue, psoriasis, ankylosing spondylitis

HLA lab

HLA antibody screening

Citrated blood

ELISA, Luminex

Sensitive and specific assays for the detection of anti HLA antibodies

HLA lab

HLA B 27

Citrated blood

Molecular, SSP

To detect B27 genotype that is associated with ankylosing spondylitis

HLA lab

<st1:stockticker w:st=”on”>AHG CDC

Citrated blood

Micro lymphocytotoxicity

A modification that enhances the sensitivity of the classical CDC

HLA lab

HLA cross match split.

Citrated blood

Micro lymphocytotoxicity

A modification of CDC that tests separately for antibodies to T and B cells

HLA lab

Luminex HLA crossmatch

Citrated blood

Luminex

A highly sensitive Luminex flow based crossmatch to detect anti HLA antibodies in a patient against HLA antigens of his donor.

HLA lab

Luminex HLA single antigen assay

Citrated blood

Luminex

A highly sensitive assay that detects and identifies the specificity of anti HLA antibodies in a particular patient. Useful for virtual crossmatches where a donor is not available for crossmatch but his typing is known.

HLA lab

Anti- Xa

Citrated blood

Chromogenic

To assess heparin levels particularly for patients on low molecular weight heparins where APTT is not useful

Special test lab

ADAMTS 13 inhibitor

Citrated blood

ELISA

Part of investigative profile for thrombotic thrombocytopenic purpura (TTP)

Special test lab

ADAMTS 13 activity

Citrated blood

Fluorometry

Part of investigative profile for thrombotic thrombocytopenic purpura (TTP)

Special test lab

ADAMTS 13 antigen

Citrated blood

ELISA

Part of investigative profile for thrombotic thrombocytopenic purpura (TTP)

Special test lab

Anti thrombin III

Citrated blood

Chromogenic assay

Part of the thrombotic workup

Special test lab

Activated Protein C resistance

Citrated blood

Clot based light transmittance and ratio

Part of the thrombotic workup

Special test lab

Apt test

NG Aspirate/vomitus/ faeces/ EDTA blood.

Alkali denaturation

Used to differentiate foetal blood from maternal blood.

Special test lab

APTT

Citrated blood

Clot based light transmittance

A screening test for coagulation, it detects abnormalities in levels and function of factors involved in the intrinsic and common pathways

Special test lab

D. Dimer

Citrated blood

Latex Immuno assay

D dimer is a product of clot lysis (fibrinolysis). High levels can indicate a significant thrombotic event accompanied by fibrinolysis. It is useful for the diagnosis of pulmonary embolism and disseminated intravascular coagulation (DIC)

Special test lab

Expression of CD 41, CD 62 P

Citrated plasma: Platelet rich plasma/ citrated blood.

Flow cytometry

To detect platelet activation

Special test lab

Expression of GP I,  GP IX expression

Citrated plasma: Platelet rich plasma

Flow cytometry

For diagnosis of Bernard Soulier Syndrome (BSS). Performed when indicated as part of the coagulation workup

Special test lab

Expression of GP II b and III a

Citrated plasma: Platelet rich plasma

Flow cytometry

For diagnosis of Glanzmann Thromboasthenia (GT). Performed when indicated as part of the coagulation workup.

Special test lab

Factor II assay

Citrated blood

One stage clot based

To assess functional levels of coagulation factor II.

Special test lab

Factor IX assay

Citrated blood

One stage clot based, chromogenic

To assess functional levels of coagulation factor IX. Levels will be reduced in haemophilia B.

Special test lab

Factor X assay

Citrated blood

One stage clot based

To assess functional levels of coagulation factor X..

Special test lab

Factor V assay

Citrated blood

One stage clot based

To assess functional levels of coagulation factor V.

Special test lab

Factor <st1:stockticker w:st=”on”>VII assay

Citrated blood

One stage clot based

To assess functional levels of coagulation factor <st1:stockticker w:st=”on”>VII..

Special test lab

Factor VIII assay

Citrated blood

One stage clot based, chromogenic

To assess functional levels of coagulation factor VIII. Levels will be reduced in haemophilia A.

Special test lab

Factor VIII antigen

Citrated blood

ELISA

To assess levels of factor VIII protein. This allows distinction between qualitative and quantitative abnormalities.

Special test lab

Factor VIII inhibitor Screen.

Citrated blood

Clot based light transmittance

To detect inhibitors to factor VIII. Haemophilia patients with inhibitors will respond poorly to factor VIII and will require other modes of treatment.

Special test lab

Factor VIII inhibitor (Bethesda) assay

Citrated blood

One stage clot based

To assay inhibitor levels.

Special test lab

Factor XI

Citrated blood

One stage clot based

To assess functional levels of coagulation factor XI

Special test lab

Factor XII

Citrated blood

One stage clot based

To assess functional levels of coagulation factor XII

Special test lab

Factor XIII

Citrated blood

One stage clot based

To assess functional levels of coagulation factor XIII

Special test lab

Factor XIII

Citrated blood

Latex immunoassay

To assess levels of factor XIII protein

Special test lab

Fibrinogen

Citrated blood

Modified von Clauss,

To assess functional levels of coagulation factor I

Special test lab

Fibrinogen

Citrated blood

Immunoturbidoemetric assay

To assess levels of fibrinogen protein

Special test lab

Haemoglobin H

EDTA blood

Supravital stain

To diagnose HbH seen in alpha thalassemia

Special test lab

Heinz body

Heparinised blood

Induced oxydant denaturation and methyl blue staining

To detect unstable haemoglobin seen in some red cell disorders haemoglobinopathies and G6PD deficiency

Special test lab

Kleihauer

Citrated blood

Acid denaturation and microscopy

To detect and quantify foetal red cells in maternal circulation for HDFN

Special test lab

Protein C

Citrated blood

Chromogenic assay.

To assess functional levels of protein C, an in vivo anticoagulant. Usually performed as part of the thrombotic workup

Special test lab

Protein S free

Citrated blood

Latex immunoassay

To assess levels of protein S, an in vivo anticoagulant. Usually performed as part of the thrombotic workup

Special test lab

Prothrombin Time (PT )

Citrated blood

Clot based light transmittance, International Normalized Ratio

To assess levels and function of coagulation factors participating in the extrinsic and common pathways i.e. factors <st1:stockticker w:st=”on”>VII, X, V, II, I

Special test lab

Thrombin generation test

Citrated Plasma: Platelet poor plasma

Fluorometry

A global test for coagulation

Special test lab

Thrombin time (TT)

Citrated blood

Clot based light transmittance.

To assess for factors that inhibit or prevent action of thrombin in coagulation eg. Fibrinogen deficiency or dysfunction, Heparin

Special test lab

Von Willebrand antigen.

Citrated blood

Latex immuno assay

Assesses the level of von Willebrand factor. Used in the diagnosis of von Willebrand disease.

Special test lab

VWF: Collagen binding assay.

Citrated blood

ELISA

Used in the diagnosis of von Willebrand disease.

Special test lab

VWF: Multimer analysis

Citrated blood

Electrophoresis

Used in the diagnosis of von Willebrand disease.

Special test lab

VWF: Ristocetin cofactor assay

Citrated blood

Light transmittance Aggregometry

Assesses the function of von Willebrand factor.Used in the diagnosis of von Willebrand disease.

Special test lab

Bile for microliths.

Bile juice

Cross polarizing microscopy

To detect microliths indicating possible gallbladder stones

IP lab

Cell counts

Synovial fluid

Microscopy

To diagnose synovitis.

IP lab

Cell counts cavity fluids

Cavity fluid

Microscopy, Improved Neubauer chamber

The count and differential count could suggest a possible cause for an effusion.

IP lab

Cell counts CSF

CSF

Microscopy

Useful to diagnose central nervous system disorders like meningitis

IP lab

Cyto spin study

CSF

Microscopy

Can help to detect abnormal cells indicating malignancy. Note: CSF cytospin for non haematological malignancies is assessed in ‘General Pathology’

IP lab

EPS analysis

Prostate fluid

Microscopy

Helps to diagnose prostatitis

IP lab

Gastric juice for haemosiderophages.

Gastric juice

Perl’s reaction

Useful to indicate blood in ingested sputum, especially in children

IP lab

Hemoglobinuria

Urine

Reflectance photometry

Hemoglobinuria indicates intravascular hemolysis (destruction of red blood cells occurring as they circulate)

IP lab

Malarial and filarial parasite

EDTA blood

Fluorescence microscopy, Microscopy thick and thin smear, Romanowsky stain

For the diagnosis of malaria

IP lab

Manual urine microscopy and crystals.

Urine

Imaging microscopy

Helps in the diagnosis of disorders involving the urinary tract

IP lab

Cytospin study

Synovial fluid

Microscopy

Helps in the diagnosis of malignancies affecting the joint

IP lab

Semen analysis – counts

Semen

Improved Neubauer counts

Used in diagnosis of male infertility

IP lab

Semen analysis – morphology

Semen

Microscopy

Used in diagnosis of male infertility

IP lab

Sickle cell preparation

EDTA blood

Sodium metabisulphiute reduction and Microscopy

Used in diagnosis of sickle cell anaemia

IP lab

Synovial fluid for crystals.

Synovial fluid

Cross Polarizing microscopy

Used to diagnose crystal arthropathy like gout

IP lab

Urine acetone

Urine

Reflectance photometry

Used to diagnose ketoacidosis

IP lab

Urine albumin

Urine

Reflectance photometry

Albuminuria may indicate disorders of the urinary tract

IP lab

Urine analysis routine

Urine

Reflectance photometry

Includes urine sugar, protein and microscopy

IP lab

Urine Eosinophil

Urine

Hansell stain, microscopy

Eosinophilia in urine may indicate acute interstitial nephritis caused by drugs

IP lab

Urine haemosiderin

Urine

Perl’s reaction

An indication of chronic intravascular haemolysis

IP lab

Urine pH and specific gravity.

Urine

Reflectance photometry

Physical properties of urine that assess the concentrating function of the kidney

IP lab

Urine phase contrast microscopy for glomerular hematuria

Urine

Phase contrast microscopy

This test assesses whether blood in urine arises from the kidney or from the lower urinary tract

IP lab
Sample collection facilities The department manages a centralised blood collection facility in OPD for the convenience of hospital outpatients and clinicians. This also minimizes pre analytical errors that may arise from non standard practice during blood collection. The main outpatient collection facility is located in the OPD building on the ground floor (G20), and supplementary ones function in the Private Consultation Facility and the centenary building’s ground floor. The main centre functions from Monday through Friday from 6 a.m. to 8 p.m., and on Saturday, from 6 a.m. to 6 p.m.. The others function from 7a.m. to 4 p.m. on all weekdays. Stool and urine sample collection for outpatients are also centralized to these spots. Collection at these facilities requires the patient to have a CMC hospital number, and the test must be ordered by a doctor employed in CMC.
The patient must carry his/her hospital card as his/her identification. A facility for depositing samples intended for testing at laboratories situated within ASHA building also operates from the ground floor of the building from 8.00 a.m. to 4.30 p.m. In addition to the ouptpatient facilities, the department organizes blood collection from the wards upto three times a day, and arranges technical assistance for bone marrow collection. Quality of care The department recognises that accurate results with efficient turnaround times are crucial for effective treatment. Each test has passed through procedures that ensure accurate and consistent results, prior to introduction.
Every step of a test, from sample collection to reporting, has a standardized procedure which is documented, to avoid inaccuracies due to deviant processing. Internal quality checks that ensure that test systems and reagents are performing well are incorporated into the daily routine for each test and process, and are recorded and systematically reviewed. Quality indicators such as turn around time (the time taken for test results to become available), sample rejection rate (the number of samples that do not meet standards for testing) and test repeat rate are routinely monitored. In addition, the laboratories participate in inter-laboratory assessments (EQAS) schemes. Blood bank components are subjected to quality checks to ensure effectiveness and safety in accordance with good manufacturing practice guidelines. Our processes have been validated by national licensing organisations as well as accreditational agencies such as the National Accreditation Bureau, for Hospitals (NABH) and for Laboratories (NABL).

Undergraduate training
BSc Medical Laboratory Technology
Eligibility: 12th standard passed in the Science (Physics, Chemistry and Biology) stream
About the course: The course is designed to produce medical laboratory technologists who are practically competent and have a sound understanding of the principles and methods involved in performing basic laboratory tests. The students are also exposed to specialized areas including molecular work and automation. By the end of the course the student will 
• Be able to independently perform routine investigations performed on blood and urine 
• Understand the principles of the techniques involved in these tests and their applications in medicine
• Understand the principles of quality management within the laboratory and be able to apply the same
Duration: 3 years
Number of seats: 12
How to apply: See under http://admissions.cmcvellore.ac.in
Post graduate training 
Diploma in Clinical Pathology (DCP)
Eligibility: MBBS
About the course: The course is designed to produce pathologists who are competent in routine laboratory management and reporting. 
Duration: 2 years
Number of seats: 2
How to apply: See under http://admissions.cmcvellore.ac.in
MD transfusion medicine
Eligibility: MBBS
About the course: Transfusion medicine is a subspecialty of clinical pathology which is involved in patient management through administration of blood cells, blood components and blood products. 
Duration: 3 years
Number of seats: 3 
How to apply: See under http://admissions.cmcvellore.ac.in
Post graduate fellowship:
PG fellowship in laboratory haematology
Eligibility: MD pathology
About the course: The course aims at producing pathologists who have specialized diagnostic skills in the area of hematopathology. 
Duration: 2 years 
How to apply: See under http://admissions.cmcvellore.ac.in
CME for secondary hospitals
The department of Transfusion Medicine and Immunohematology in collaboration with the Department of Clinical Hematology conducts a CME for doctors and laboratory personnel of secondary hospitals to help them to improve their diagnostic and therapeutic services in blood banking and hematology.  This is a week long program conducted in the month of September each year.

Associate Professors

Contact Information

Address :

The Head
Department of Transfusion Medicine and Immunohematology (Hematology)

Room 9, 5th floor, ASHA Building

Christian Medical College Vellore

Ida Scudder Road, Vellore – 632004

Tamil Nadu, India 

Email us :

clinpath@cmcvellore.ac.in

Reach us :

04162282533

Working hours :

Mon-Fri: 8 am to 4.30 pm

( Sat : 8 am to 12:30 pm)