Section of Laboratory Medicine

Mission Statement

The University of Pittsburgh Department of Pathology Section of Laboratory Medicine is committed to being an international leader in all aspects of Laboratory Medicine (Clinical Pathology): patient care, academic productivity, and trainee development. To accomplish and maintain these missions, the Section must provide both career development and necessary facilities to faculty.

Research Activities

The research endeavors of the faculty of this Section are varied from basic cell biology through systems biology to patient-directed translational investigations; these combined efforts form a large part of the academic mission of the Department of Pathology.

The research endeavors of the Section continue to evolve though they remain quite substantial. The past year has been productive with many faculty obtaining stable grant funding and expanding their published works. This is especially gratifying considering the national state of support for research. This involves funding from multiple federal sources, mainly NIH and the VA, but also private foundations and industry. This coming year we are recruiting to replace Dr. Nahed Ismail and partnering with the VA to increase our research in microbiology. We are pleased to announce that Dr. Hun-Way Hwang's advances have been recognized by significant extramural funding to fully launch his research efforts on RNA processing in neuropathology.

Teaching / Training Activities

The amalgamation of the various Divisions has improved the Laboratory Medicine training of residents, resulting in increased continuity and comprehensiveness of training among the disciplines that comprise the Section. The residency program has been revamped to take advantage of the unique situation at University of Pittsburgh Medical School and UPMC. The network of academic and community hospitals provide an exceedingly broad range of clinical materials and patient care interactions; a new mandate on junior lab director rotations utilizes the VA and community hospitals to provide a realistic experience in small hospital settings.

The fellowship programs in many of the constituent Divisions (Hematopathology, Clinical Chemistry, and Transfusion Medicine, in particular) and affiliated Departmental Divisions (Molecular Genetics Pathology and Transplant Pathology) are being integrated more deeply into the pan-Laboratory Medicine approach. This is a real boon, as the traditional lines of clinical support are blurring with advances in scientific understanding and technology. In response to our overall strategic plan last spring, we will be focusing more on fellowships.

With the ongoing strengthening of the basic investigative research component in the Section, graduate and post-doctoral education has emerged as a major focus. There are about nine graduate students from various Departments and Institutions undertaking their thesis work in the laboratories of faculty of the Section. In addition to the graduate students, a large number of post- doctoral fellows are training within these laboratories. For this latter group, members of the Section have become deeply involved in the Departmental endeavor to improve post-doctoral training and provide important tools for career progression during this difficult transitional stage.

Clinical Activities

The Section of Laboratory Medicine encompasses the Divisions of Clinical Chemistry, Hematopathology, Immunopathology, Clinical Microbiology and Virology, and Transfusion Medicine. This structure enhances the interdisciplinary approaches that improve the academic, teaching, and service missions of these Divisions. Dr. Wells serves as a Vice-Chair and Section Director. Individual Divisions and Directors present complementary specialized approaches to patient care and education, which in total represent the whole of Laboratory Medicine - a clinical approach to patient care directed from an outcomes-and-data-based diagnostic testing modality.

Over the past year, we said farewell to Dr. Nahed Ismail of Microbiology who moved to take the Division directorship at University of Illinois at Chicago, and Dr. Ray Hariri of Microbiology who is moving on to a new phase this summer, and now a tull farewell to Dr. Massimo Mangiola who has moved to Boston for family reasons, but had been returning frequently to support our Tissue Typing/Transplant efforts. We have successfully recruited to fill in these areas. Dr. Tung Phan is joining us after finishing his Microbiology fellowship in Indianapolis, and Dr Qingyong Xu as associate director of Tissue Typing.

A major effort is to provide direction and integration across the now over 40 hospital laboratories that comprise UPMC, with the recent addition of hospital networks in the central parts of the state and a hospital in Somerset. This has improved medical delivery and ease of moving patients and physicians across the system, as well as saving the laboratories significant resources which have redeployed in new endeavors. The upcoming year promises to be eventful as we focus on further integration of the Pathology and Laboratories Service Center utilizing the resources of the Clinical Laboratories Building (CLB). However, given the geography and transport issues involved, we are partnering with the central PA networks to help them establish their own regional high complexity testing laboratories.

UPMC and Quest Diagnostics, Inc. have established a laboratory joint venture known as the Quest Diagnostics Joint Venture. The Joint Venture laboratory is located in Greentree and serves the geographic region within 150 miles of Pittsburgh - excluding existing Quest Diagnostics, Inc. Joint Ventures in Erie. A key component of the Joint Venture is the medical and doctoral scientist leadership provided by the Department of Pathology. The faculty support the Joint Venture and are responsible for the quality of care and quality of service provided by the Joint Venture Laboratory.

The initial focus of the Joint Venture is on Clinical Pathology "Outreach" testing. Physician offices and long term care facilities have already begun to transfer their tests from UPMC hospital laboratories to the Joint Venture Laboratory. UPMC hospital laboratories also use the Joint Venture Laboratory as their Reference Laboratory. The Joint Venture aims to: 1) improve the quality, consistency and reliability of laboratory testing across multiple clinical settings of patient care, 2) enhance information technology connectivity to permit electronic order entry and results reporting, future integration of diagnostic test reports, and data archiving capability, and 3) improve laboratory efficiency and service through consolidation of infrastructure support such as patient service centers, courier services, and client service to achieve significant system-wide cost reductions while providing an opportunity to enhance the quality of care and quality of service to physicians and patients.

Six years ago, Pathology in conjunction with the UPMC International and Commercial Services Division established a laboratory in collaboration with a new oncology-focused specialty hospital in Hyderabad, India. AmPath was recently merged into the American Oncology Institute and Citizens Hospital structure with a renewed emphasis on serving all of India; UPMC is not providing expertise to all aspects of this enlarged venture. This was the first venture for UPMC in the subcontinent, and represented an opportunity for training and development in global health for our faculty and trainees. This laboratory is opened 18 months ago as a core of chemistry, hematology/coagulation, flow cytometry, microbiology, surgical pathology/cytology and immunohistochemisty. Over the past year we have brought on molecular diagnostics in microbiology and anatomic pathology, tissue typing, transfusion services and other high end services this next year. The success of this venture has opened new opportunities in Kazakhstan and elsewhere, which are still in the process of development.

Goals and Objectives

The goals for the upcoming year are to maintain our high level of excellence and productivity in all aspects of academic Laboratory Medicine. We aim to increase our research base primarily through building the current investigative laboratories and the addition of new recruits. One reason for this optimism is the increasingly collaborative nature of our section members thus leveraging their expertise. Also, as the growth in clinical faculty has finally caught up with the increased work load, the academic productivity of this group of faculty has increased. In addition, there are intriguing new efforts involving both investigative and clinical academic faculty in systems biology and new relationships with critical care medicine.

We aim to better educate our clinical trainees with a re-engineered residency training program with more clearly defined curricula and evaluations and teaching modalities. As the investigative laboratories have blossomed, our graduate and post-graduate training efforts should grow as we attract more and better quality graduate students and post-doctoral fellows. This will be evaluated by number of trainee publications, presentations, and awards/recognitions. We are in the process of recruiting for additional funded investigators to enhance this setting.

Clinical enhancements are also targeted along with maintaining a high level of individual case excellence. We are initiating new diagnostic modalities in automated testing, special chemistry and tissue typing. We are in the midst of re-organizing the clinical laboratory structure throughout UPMC so as to strengthen our specimen quality and make the entire diagnostic loop from physician order to resulting more efficient and useful.