November 2021
Anatomic Pathology Updates
We are delighted to announce our new Director of Surgical Pathology, Dr. Gregory Gates. In this role, Dr. Gates will be responsible for overseeing the operation of the Division of Anatomic Pathology, which includes the following services: Autopsy, Cytopathology, Surgical Pathology, Hematopathology, Molecular Pathology, Cytogenetics, and Neuropathology. Dr. Gates will continue in his current role as the Director of Immunohistochemistry lab. Please join us in congratulating Dr. Gates and we look forward to his leadership in this important role!
Clinical Pathology Updates
The Division of Microbiology under the direction of by Dr. Omai Garner, not only plays an essential role in patient care, but also is continuously collaborating with UCLA Infection Prevention to prevent healthcare associated infections. In July 2021, the UCLA Infection Prevention team noticed a cluster of bacteremia cases with Burkholderia cepacia complex (BCC), a group of environmental Gram-negative bacteria that are frequently associated with nosocomial infection. Coincidentally, several institutions across the nation also reported an unusual increase of BCC bacteremia cases. Through active communication with other clinical microbiology laboratories, the UCLA Clinical Microbiology lab directors, Drs. Garner, Shaun Yang and Suki Chandrasekaran, learned that ultrasound gel used prior to intravenous catheter insertion was suspected as the source of the bacteria. Using microbial whole-genome sequencing (WGS), the bacteria isolates were quickly characterized. Furthermore, our Clinical Microbiology lab provided high-resolution genetic information and revealed that these bacteria, along with the bacteria isolated from other institutions, were essentially identical; the bacteria were identified as Burkholderia stabilis, indicating a nation-wide outbreak with the same source of contamination. In the meantime, culture of samples from the ultrasound gel grew the same bacteria as proven by WGS. Based on definitive information generated by our microbiology lab, Infection Prevention immediately replaced the ultrasound gel with another vendor’s product at all clinical locations throughout UCLA Health. No new B. stabilis bacteremia has occurred since cessation of the brand of ultrasound gel associated with the contamination. The astute investigation and collaboration between the UCLA Clinical Microbiology Laboratory and the Infection Prevention team quickly identified the source and contained the outbreak in less than one month. This case, as well as many others, demonstrate the value of the robust microbial genomic surveillance system that the UCLA Clinical Microbiology lab has established by using WGS to assist in outbreak investigation in real-time.
Additionally, we are pleased to announce our Faculty and Department made the decision to change the Clinical Pathology Division’s name to Laboratory Medicine to accurately reflect their activities.
Immunogenetics Updates
Clinical
The UCLA Immunogenetics Center (UIC)IC provided Histocompatibility and Immunogenetics testing for 790 solid organ transplants for the 5 transplant centers we serve (UCLA, UC Davis, Harbor-UCLA, Scripps Green Hospital, Saint Joseph’s Orange) and performed Histocompatibility testing for 25 kidney paired donations at UCLA. UIC established new partnerships with USC, Loma Linda, Cedars Sinai and Children’s Hospital Los Angeles to provide crossmatch testing to support the new United Network for Organ Sharing kidney transplant allocation policy.
UIC successfully completed several strategic Information Technology Projects. A major goal was to build the UC Davis electronic medical record with historical donor and recipient transplant information prior to 2019. This project called the “UC Davis Historic Load” was completed in a comprehensive electronic record of all of UC Davis’s transplant patient data. This will greatly enhance patient care and clinical research. UIC has also validated and deployed new workflows and processes to improve efficiencies for EPIC and Beaker billing. Another major accomplishment was establishing electronic reporting of deceased donor HLA typing from UIC Histotrac to One Legacy OPO Digital Donor. Recent changes in United Network for Organ Sharing policies required UIC to establish order/reporting and sample storage workflow for 10-year Storage of Living Donor Samples in accordance with UNOS Policy Change. Another major accomplishment was the implementation of the MediaLab document control system in August of 2021.
UIC welcomes Amy Ramirez, Client Services Supervisor and Dr. Rebecca Sosa, Health Sciences Assistant Professor to our team.
Quality
UIC continues to build upon its quality program. Five major quality projects were implemented and completed including:
Education
The UIC educational program led by Jennifer Zhang, Ph.D., leveraged the zoom platform to expand training in Immunogenetics and Histocompatibility testing to our partner institutions. The faculty taught 5 educational lecture series consisting of 6 seminars to pathology residents, pathology fellows, transfusion medicine fellows, clinicians and transplant coordinators at UCLA, UC Davis, Harbor-UCLA, Scripps Green Hospital, Saint Joseph’s Orange, One Legacy, and Kaiser Permanente Southern California.
Research
UIC faculty and fellows published 21 publications and Dr. Elaine Reed was awarded 1 new NIH grant. Dr. Reed received a philanthropic grant donation from an Aestiva Software Founder, to establish a post-doctoral research fellowship focused on understanding mechanisms of antibody mediated heart transplant rejection.
UIC welcomes Meagan Jenkins, PhD joined the Reed Lab as new Postdoctoral Scholar. Her research is aimed at understanding cellular immunity to SARS-CoV-2 and correlates of immune protection.
UIC serves as CAP proficiency test provider since 2003 and has provided educational and proficiency testing programs to the Immunogenetics Community for 47 years. Given the recent interest in non-classical HLA genes in transplantation and disease association the UCLA Cell Exchange program added analysis and reporting of non-traditional HLA loci (HLA-E, -F, -G, -H, MICB) to the DNA Exchange proficiency test program.
Sarah M. Dry, MD
Professor & Chair, Department of Pathology & Laboratory Medicine
