1) The Diagnostic Coagulation Laboratory is now well-equipped and fully automated, covering virtually the entire spectrum of phenotypic tests available anywhere in the world. This laboratory essentially functions as the problem-solving and reference laboratory for coagulation disorders in Iran. Over 40% of the lab. work-load comprises referrals from all parts of the country.
World Health Organisation(WHO) Standards for coagulation factor VIII & factor IX measurement are utilized to ensure accuracy and reproducibility.
Secondary Iranian standards, validated against the WHO standard material, have also been produced for distribution to provincial diagnostic laboratories, in order to ensure comparability between laboratories.
The laboratory participates in the two-monthly UK NEQAS (National External Quality Assurance) proficiency testing exercises, and has recently initiated a 4-monthly IRAN NEQAS programme for provincial centres.
Training 'wet' Workshops for technicians from provincial laboratories throughout Iran, are held in a section of the lab. with 4 work stations, in order to raise standards of accuracy.
2) The Molecular Genetics Laboratory determines precise genetic mutations of affected families by direct DNA sequencing - an exceptionally accurate methodology which is not currently available elsewhere in Iran or in most other Regional countries. Families in Iran are exceptionally large, sometimes amounting to as many as 100 individuals! Once the familial mutation has been identified, the carrier status of all the girls in these huge pedigrees can be confidently established.
This provides the opportunity for counseling young women from affected families regarding marriage, future pregnancies, and their reproductive choices.
Prenatal diagnosis: Young women known to be carriers of the defective gene, who do become pregnant, can have the gender of their foetus determined at 9 to 10 weeks of pregnancy, as a prelude to chorionic villus biopsy(CVS) of male pregnancies, in order to find out whether the foetus is affected by haemophilia or not.
Overall, the genetic mutations of over 250 haemophilic families have been determined so far, and the carrier status of well in excess of 400 young women has been determined in this way.
3) The General Laboratory mainly serves patients from the Haemophilia
Centre and carries out routine biochemical and haematological investigations, together with screening tests for hepatitis B, C and HIV. Since over 70% of
Iranian haemophiliacs are infected with hepatitis C, with or without co-infection with HIV, viral load determination and HCV genotyping is also carried out as a vital guide for management and prognosis of these patients.