This twelve-week program focuses on laboratory practices and test interpretation involved in the diagnosis of thrombosis and hemostasis disorders. Training areas include basic and advanced clotting tests, laboratory diagnosis of Von Willebrand Disease (VWD) phenotypes, platelet function testing, and thrombophilia diagnosis.
Training Program Schedule:
- Global Laboratory function, theoretical updating on hemostasis process, including platelet function, clotting and fibrinolytic systems and natural anticoagulants. (Week 1)
- Basic clotting tests, preparation of plasma pool control, quantitation of clotting factors, screening and identification of antibodies. Laboratory control of heparin and new anticoagulant drugs. Pre-analytical and analytical controls. Report of results. Internal and external quality control processes. (Weeks 2-4)
- Training in VWD testing and diagnosis: VWF:Ag, VWF:RCo, VWF:CB, RIPA, FVIII binding to VWF, Multimeric analysis of VWF, ADAMTS 13 assay. Laboratory diagnostic criterium. (Weeks 5-6)
- Training in platelet function testing: platelet aggregation and serotonin secretion, including diagnostic criteria; platelet procoagulant activity, detection of anti-platelet antibodies, diagnosis of platelet glycoprotein deficiencies and platelet compatibility testing by flow cytometry. (Weeks 7-9)
- Inherited and acquired thrombophilia diagnosis: measurements of antithrombin and protein C by functional (coagulometric assay) and antigenic (ELISA assay); protein S antigen (ELISA), activated protein C resistance (coagulometric assay), diagnosis of FV Leiden and prothrombin C20210A mutation (PCR, lupus anticoagulant screening and confirmation assays. HIS diagnosis: anti-heparin-PF4 antibodies and serotonin release assay (by HPLC) (Weeks 10-12)
Trainees also attend weekly bibliography and research meetings as well as meetings to review, analyze, and interpret all tests performed on Wednesday and Friday each week. The trainee is asked to give a final seminar at the end of his or her stay.
If the trainee is a physician, he/she will have the chance to attend in- and out-patient specialized clinical practice and out-patient anticoagulant clinic during his/her last 6 weeks stay. During his/her entire stay, training supervisors explore realistic avenues of collaboration and continued improvement with the trainee and his/her home institution.
Requirements for Candidates to this program:
- Applicants must accredit a title of MD, PhD, biochemist, or laboratory technician.
- Applicants must direct or work in a Diagnostic or Research Thrombosis and Hemostasis Laboratory or in the Thrombosis and Hemostasis section of a Clinical Laboratory of a his or her hospital. The trainee’s laboratory must be equipped with automatic coagulometers and ELISA facilities. If not available, they must commit to develop in their center the study of platelet aggregometry and the molecular diagnosis of Factor V Leiden and G20210A prothrombin mutation. The trainee can get additional benefits if he/she has access to flow cytometry and molecular diagnosis at his/her home Institution.