Core Laboratory

Transfusion medicine

The Transfusion Medicine Service and Patient Blood Management Program at Mount Sinai Hospital are designed to meet the complex transfusion needs of patients. They serve both medical and surgical patients, whether they are staying in the hospital or receiving outpatient care.

In addition to providing transfusions, we offer consultation and educational support for patients, health-care providers, our partners and other hospitals. Our team specializes in areas unique to Mount Sinai, such as maternal fetal health, complex orthopaedic surgery and oncology.

Our routine blood bank performs screening, diagnostic testing and specialized diagnostic procedures such as flow cytometry for measuring fetal maternal hemorrhage.

We are also equipped to prepare blood products tailored for specific situations, such as:

• Pregnancies involving sickle cell disease
• Intrauterine transfusions for red cell and platelet alloimmunized pregnancies
• Transfusions in the neonatal intensive care unit (NICU)

Hematology

General hematology

Our lab team conducts comprehensive tests on blood or plasma to detect infections and blood-related disorders such as leukemia. Common tests include the automated complete blood count (CBC) and blood cell morphology. These tests assess red blood cells, white blood cells and platelets to help diagnose anemia, infections, leukemia and other blood disorders.

We also offer a range of other diagnostic tests, including:

• Erythrocyte sedimentation rate (ESR)
• Reticulocyte count
• Bone marrow analysis
• Body fluids analysis
• Malaria testing

Coagulation 

Our lab team performs essential coagulation tests, such as:

• Prothrombin time (PT)
• Activated partial thromboplastin time (APTT)
• Fibrinogen
• D-dimer
• Anti Xa levels

These tests help diagnose, treat and monitor bleeding disorders and clotting (thrombotic) issues.

The lab also does specific tests, such as clotting factor checks (assays), testing for lupus anticoagulant and investigating Von Willebrand disease.  

Flow cytometry

In the flow cytometry lab, we use fluorescent labelled antibodies to find, identify and count antigens on white blood cells and red cells. These cell features, called immunophenotypes, help diagnose and treat conditions like leukemia, lymphoma and immunodeficiency. They can also help detect bleeding between a mother and her unborn baby (fetal-maternal hemorrhage).  

The specimen types we analyze include peripheral blood, bone marrow, body fluid and biopsy tissues.  

Hemoglobin electrophoresis

This test looks at different types of hemoglobin in the red blood cells. The types include hemoglobin A, A2, F, S, C, and different hemoglobin variants. It checks for any unusual types of hemoglobin and helps diagnose conditions like sickle cell disease, thalassemia, hemoglobin C and other hemoglobin-related issues.

This test can be ordered as part of prenatal genetic screening.

Biochemistry

Routine biochemistry

In routine biochemistry, our lab team uses both automated and manual methods to analyze blood, urine, and other body fluids from patients.

We provide a wide range of tests to help monitor and diagnose health conditions in both urgent and ongoing care situations. These tests include evaluations of enzymes, toxicology, drug levels, hormone levels, tumour markers and urinalysis, among others.

Special biochemistry

We perform special biochemistry testing for various medical specialties, using both automated and manual methods.  

These tests cover areas like fertility, prenatal testing, autoimmune disorders, endocrine disorders, plasma cell dyscrasias and inflammatory bowel disease.

Immunology

Our lab team checks for the presence of antibodies that attack the body (autoantibodies). We also check for signs that the body is responding to specific germs (microbial agents). We can identify abnormal proteins that might indicate diseases such as multiple myeloma or cyroglobulinemia.

Finding autoantibodies can help diagnose conditions, such as:

• Systemic lupus erythematosus  
• Sjögren's Syndrome
• Rheumatoid arthritis
• Myositis
• Anti-phospholipid syndrome
• Celiac disease

We can test for a broad spectrum of infectious diseases like Lyme disease or syphilis. Expert consultation and interpretation of laboratory tests are available for immunology testing. 

Point-of-care testing

Point-of-care testing is testing done at the bedside or near the patient. This way, the patient, physician and care team can get the results quickly and make important decisions about treatment without waiting too long.  

Tests for things like glucose (blood sugar), blood gases and automated urinalysis (urine testing) are often done this way.  

Prenatal genetic screening

Prenatal multiple marker screening (MMS) is offered between 11 and 20 weeks of pregnancy. It checks the likelihood of certain genetic conditions or birth defects in a fetus. These conditions include Down syndrome (trisomy 21), trisomy 18 and open neural tube defects.  

Our lab uses an algorithm to predict risk that considers the patient's:

• Age
• Medical history
• Pregnancy-specific details
• Specific markers from blood tests and imaging like a nuchal translucency scan

Sinai Health offers blood screening to all pregnant patients. This program is part of Prenatal Screening Ontario, which has oversight of quality province wide.

Specimen management

Specimen management involves the safe handling of laboratory samples. This includes sending samples to other labs for specialized testing and ensuring proper storage and disposal procedures are followed. Samples are categorized as urgent (STAT) or regular (routine) to ensure timely results. Meticulous tracking ensures each sample’s location within the lab is accounted for.