Clinical Chemistry and Point-of-Care Testing

The Clinical Chemistry Laboratories play a critical role in the diagnosis and monitoring of disease by measuring numerous analytes and biomarkers in serum and other bodily fluids, performing over 1 million tests annually throughout our Health System that comprises six campuses (TUH-Main campus, TUH-Episcopal Campus, TUH-Northeastern Campus, TUH-Jeanes Campus and TUH-Fox Chase Campus).

The Temple University Hospital (TUH)-Main Campus laboratory is equipped with the Siemens Aptio Automation system which includes the Dimension Vista 1500 and EXL 200 and the Advia Centaur XPT. Blood gas and co-oximetry are performed on RAPIDLAB 1265 and urinalysis is run on the Clinitek Novus and Sysmex UF-1000i. AmniSure ROM for rupture of fetal membranes, osmolality (Advanced Instruments), and the fetal fibronectin test (Hologic) are performed manually. The other campuses have a mix of instrumentation from Siemens, Beckman and Abbott that has been selected by the laboratory to support the specialty service the campus provides. Together in concert, the clinical chemistry laboratories in the health system provide a rapid turnaround time, 24/7 coverage, and a rich laboratory experience for trainees.

The Point-of-Care (POC) Testing Service oversees testing outside of the clinical laboratory and is carried out by healthcare personnel at the bedside in both outpatient and inpatient settings. Current instrumentation includes TEG, Hemochron Signature Elite, ACT Plus, and CoaguChek XS for hemostasis evaluation in the surgical suites, the heart failure unit, and the cardiac catheterization laboratory. These sites also use the Avoximeter 1000E and RAPIDPoint 500 instruments for blood gas analysis and co-oximetry. Other instruments and tests, including the Clinitek Status +, BD Check Group Strep A test, Hemocult Sensa, Hydrion pH paper, physician performed microscopy Sure-Vue pregnancy test, Alere Determine HIV-1/2 Ag/Ab Combo, StatStrip glucose meter, and the StatSensor creatinine meter, are used in various parts of the hospital system including the Emergency Department, intensive care units, Obstetrics and Gynecology, Occupational Health, the dialysis unit, and specialist centers such as the Digestive Disease Center, the Heart and Vascular Institute, the Lung Center, the Neurosciences Center, the Orthopedics and Sports Center, and the Abdominal Organ Transplant Program. SARS-Cov-2 testing using the Cepheid GeneXpert Xpress is also performed for urgent outpatient cases where a quick diagnosis improves patient management, particularly in the ED.

The Clinical Chemistry and Point-of-Care Testing Service is actively involved in the training of medical students, students of podiatric medicine, pathology residents, and endocrinology fellows. We also provide expertise and leadership to the Clinical & Laboratory Standards Institute, the American Association for Clinical Chemistry, and the International Federation of Clinical Chemistry and Laboratory Medicine.

Faculty

• Adil Khan, MSc, PhD (Director, Clinical Chemistry and Point-of-Care Testing)
• Melissa Ulas (Co-Director, Clinical Chemistry and Point-of-Care Testing) 

Immunogenetics

The Immunogenetics laboratory provides crucial services related to HLA testing. It is an integral member of the Temple University Hospital solid organ transplant programs (including heart, lung, liver, kidney, and pancreas transplants) and the bone marrow transplant programs based at the Fox Chase Cancer Center and Jeanes Hospital. As these clinical services have expanded in recent years, the Immunogenetics laboratory has experienced a significant increase in test volume, performed over 19,000 annually, and is expected to continue growing.

The laboratory performs a variety of tests including: pre-transplant histocompatibility risk assessments, low- and high-resolution HLA molecular typing, T-cell and B-cell crossmatches, virtual crossmatches, identification and quantification of anti-HLA antibodies, and post-transplant monitoring for anti-HLA antibody mediated rejection. The laboratory also offers diagnostic HLA testing related to disease associations and medication hypersensitivity associations. Accordingly, the laboratory is equipped with several state-of-the-art testing platforms including next-generation sequencing (NGS) for high-resolution HLA typing, LabScans 3D for intermediate-level HLA typing and anti-HLA antibody testing, and Canto flow cytometers for crossmatching.

The technologist staff of the Immunogenetics laboratory, many of whom have advanced accreditation through the American Board for Histocompatibility and Immunogenetics (ABHI), performs both routine and STAT-priority testing with continuous 24/7 coverage that ensures timely results. The Immunogenetics faculty are heavily involved in local hospital administrative and transplant committees, as well as with national organizations including the American Society of Histocompatibility and Immunogenetics (ASHI) and the United Network for Organ Sharing (UNOS). In addition, the laboratory is involved in both clinical research and teaching of various healthcare professions students, medical residents, and fellows.

Faculty

• Steven S. Geier, PhD, D(ABHI) (Co-Director, Immunogenetics)
• Hamid Liacini PhD, D(ABHI), D(EBTI) (Associate Director, Immunogenetics)

Transfusion Medicine

The Transfusion Medicine (TM) section provides clinical service coverage for the blood bank and transfusion services at Temple University Hospital (TUH), an academic level I trauma center with active emergency, trauma surgery, transplant surgery, obstetrics, hematology/oncology, and adult and neonatal intensive care services. The TUH blood bank utilizes a combination of automated gel-method and conventional manual methods for serology and blood product compatibility testing, performs over 60,000 tests annually, and issues approximately 20,000 blood products annually. The TM section at TUH-main campus also provides medical direction for the blood bank at the Jeanes/Fox Chase Cancer Center campus and the satellite blood bank at Episcopal Hospital/Northeastern Campus. In addition, we supply blood products and provide blood bank testing services to Shriners Hospitals for Children- Philadelphia.

The TM section at TUH-main campus also provides medical direction for the therapeutic apheresis service at TUH, offering consultation and oversight for a wide range of inpatient and outpatient procedures including therapeutic plasma exchange, red cell exchange, leukocytapheresis, and extracorporeal photopheresis. Active consulting services include transplant surgery, pulmonology, cardiology, nephrology, hematology, and neurology. A total of 350 apheresis procedures were performed in FY20 with expected, continual growth.

On the academic front, the TM section is actively involved in teaching and training of medical and podiatry students, physician assistant students, pathology residents, podiatry residents and hematology/oncology fellows. Furthermore, the TM section actively participates in local and national clinical research.

Faculty

• Mohamed Alsammak, MD (Director, Transfusion Medicine)
• Andy Hgo, MD (Associate Director, Transfusion Medicine)

Microbiology & Immunology

The Temple University Hospital Clinical Microbiology and Immunology section is a full-service laboratory in bacteriology, virology, mycobacteriology, mycology, parasitology, and immunology. We serve patients at Temple University Hospital, Shriner’s Hospital for Children, TUH-Episcopal Campus, Jeanes Hospital, and the Fox Chase Cancer Center, performing over 100,000 tests annually.

The laboratory is equipped with instrumentation for detection, isolation, and characterization of infectious agents, using rapid molecular assays where appropriate to optimize patient care.  Increasingly, we have been leveraging the speed and accuracy of mass spectrometry to enhance laboratory identification of bacteria, fungi, and mycobacteria. The laboratory leadership works closely with the infectious diseases, emergency, transplant, infection prevention, and antimicrobial stewardship services to ensure high quality patient care.

In addition to our clinical services, we are actively engaged in various research initiatives that focus on antimicrobial resistance mechanisms and the clinical impact of diagnostic stewardship initiatives. Our laboratory supports the training of pathology residents, infectious diseases fellows, and rotating trainees from the School of Podiatric Medicine and the Kornberg School of Dentistry at Temple University. Finally, our laboratory leadership provides expertise to a number of national organizations including the College of American Pathologists, the Clinical & Laboratory Standards Institute, and the Healthcare Infection Control Practices Advisory Committee.

Faculty

• Raghava Potula, MHA, PhD (Director, Microbiology and Immunology)
• Kaede Ota Sullivan, MD, MSc (Associate Director, Microbiology and Immunology)

Hematology & Coagulation

The Hematology and Coagulation Laboratory at Temple University Hospital provides diagnostic evaluation of hematolymphoid disorders, as well as specialized testing for disorders of hemostasis and thrombosis. It offers services to TUH and its affiliated outpatient clinics, Episcopal Hospital, Northeastern Campus, and Shriners Hospital for Children – Philadelphia. The laboratory also provides referral diagnostic services for Jeanes Hospital and the Fox Chase Cancer Center.

The laboratory performs nearly 500,000 tests annually and evaluates a wide variety of specimen types including peripheral blood, bone marrow aspirates, and other bodily fluids. A combination of automated instrumentation for most routine testing with manual medical technologist involvement and review ensures timely, accurate, and precise results. The laboratory also receives fine needle aspiration and surgical specimens for work-up for hematopoietic disorders/malignancies. In addition, the growing flow cytometry sub-section utilizes BD FACS Canto instrumentation to provide accurate diagnostics and immunophenotyping for disorders of immune dysregulation and hematopoietic malignancies. Comprehensive interpretation and diagnosis are provided by our expert hematopathologists.

The Hematology and Coagulation service is actively involved in the teaching of pathology residents, hematology/oncology fellows, and rotating medical, dental, podiatry, and medical technology students. The laboratory also supports ongoing research initiatives and its faculty are actively involved with several national organizations including the College of American Pathologists and the American Society for Clinical Pathology.

Faculty

• Ashish Bains, MD (Director, Hematology and Coagulation)
• Mohamed Alsammak, MD
• Jeff Fu, MD, PhD

Molecular Pathology

The Molecular Pathology Laboratory at Temple University Hospital uses progressive state of the art technologies to provide diagnostic services in the areas infectious diseases, inherited disorders and oncology. In addition to a variety of FDA-approved tests, the laboratory offers esoteric advanced diagnostic tests for personalized genomics. Our laboratory performs qualitative and quantitative Real-time PCR, DNA hybridization, microarray technology, capillary electrophoresis, and next generation sequencing. The molecular menu includes mutational analysis for Factor V Leiden, Factor II Prothrombin, HIV viral load quantitation and genotyping, hepatitis C viral quantitation and genotyping, CMV, EBV, and BKV quantification assays. Next generation sequencing panels for detection of actionable mutations in solid tumors has been introduced recently in the laboratory. The laboratory is also working on introduction of molecular testing for myeloid malignancies.  Additionally, clonality and gene rearrangement assays for diagnosis and monitoring of lymphoid tumors are being introduced.

The laboratory is dedicated to supporting a diverse spectrum of services at Temple University Hospital. We work very closely with the solid organ transplant program at TUH to ensure that transplant candidates receive the highest level of diagnostic support possible starting at pre-transplant assessment through post-transplant care. The faculty is dedicated to provide training to the students and residents for real world experience in a molecular diagnostics laboratory at Temple University hospital.

Faculty

• Anjali Seth, Ph.D, D(ABCC) (Director, Molecular Pathology)