There are so many careers to choose from within the world of healthcare. This behind the scenes insight gives you a look into the life of a Healthcare Scientist who studied Biomedical Sciences at University and now has spent many years working in the NHS.
Day in the life of a Healthcare Scientist working in Immunology and Immunogenetics
The Transplant Immunology and Immunogenetics laboratory supports the Oxford Transplant Centre, which provides kidney, pancreas, intestinal and islet cell transplant services and other surgery for patients at the Oxford University Hospital NHS Foundation Trust. Our pancreas transplant programme is now the most active in Europe. My experience will be broadly similar to that of any of the other Healthcare Scientists working in this field.
Woken up by my alarm in plenty of time to get ready for the day ahead. The commute into Oxford takes 40 minutes through normal traffic, so I always make sure to plan my journey.
Arrive at my department and, pausing only to store my coat and lunch in my locker, head straight into the laboratory. This morning I am performing antibody identification tests, using samples from patients who are waiting for solid organ or bone marrow transplants. These tests will take between two to three hours to perform, and are important as they allow us to detect whether patients are producing antibodies against HLA.
Human leukocyte antigens (HLA) are markers found on the surface of cells in the blood and other places around the body. There are many different forms of HLA and each person has only a limited number. We inherit HLA from our parents in a combination called our ‘HLA type’.
If a donor HLA type differs from the patient, it is said to be ‘mismatched’. When cells or tissues are transplanted from one person to another, the patient’s body can recognise these mismatches as ‘foreign’. This can cause the patient’s immune system to respond by trying to destroy the transplanted cells, which is called ‘rejection’.
Sat down to analyse the results from the antibody identification tests. Any antibodies detected by these tests are added to the patient’s record, and the national transplant waiting list can then be updated with a list of unacceptable HLA mismatches; this is done to reduce the chance of rejection.
A chance to take a break from the computer, and sit down and eat my lunch.
The weekly transplant multi-disciplinary team (MDT) meeting, where patients awaiting or recovering from transplant can be discussed. Sat around me are microbiologists, nephrologists, nurses, pharmacists, scientists and surgeons; allowing everyone to be able to input where needed to guide the treatment of patients. I provide information to surgeons on any donor mismatches or patient antibodies present, which cause the amount or type of immunosuppression drugs given to a patient to be altered.
Back in the laboratory again, where the next few hours are spent designing and testing primer mixes for PCR plates. These are used to determine the HLA type of patients and donors.
Grab my coat and leave the department after a busy week. But my work doesn’t stop here, as I am the on-call scientist today. This means that I need to be available overnight should any organs from deceased donors be offered to patients on the Oxford transplant list.
After a nice evening meal and a relaxing evening, it is time for bed!
Woken up by my on-call phone, after only an hour of sleep. An organ from a DBD donor is been offered to one of the patients on the kidney transplant list.
Donation after Brainstem Death (DBD) is possible from patients whose death has been confirmed using neurological criteria. Brain damage is often caused by a serious accident, stroke, or cerebral haemorrhage. A person who is brain dead can no longer feel any pain and is no longer conscious. The body is given artificial respiration to allow the heart, lungs, liver, pancreas, kidney and small intestines to remain suitable for transplantation.
The HLA type of the donor has been provided by their local transplant lab; I double-check this against the patient’s record, and then contact the consultant on-call surgeon for a discussion of the offer. As the patient has not produced any donor-specific antibodies in the samples we have previously tested, the surgeon agrees that the offer should be accepted. This means that the patient will be called in and prepped for surgery, while I need to perform crossmatching tests at the laboratory overnight.
Crossmatching tests are an important part of the transplant procedure. Blood from the donor and patient are mixed. If the patient’s cells attack and kill the donor cells, the crossmatch is considered positive; which means the patient has antibodies against the donor’s cells. If the crossmatch is negative, the donor and recipient are considered compatible.
Arrived at the laboratory at the same time as the ambulance delivering the donor blood samples. Crossmatching takes roughly 6 hours, during which I perform two different crossmatching techniques, and also confirm the HLA type of the donor. This is a very involved process, with many steps, but I manage to find time to down a cup of coffee which helps with the tiredness.
All of the testing has finished, and I ring the head of my laboratory to authorise the results. Once this is done, I can report the results to the consultant surgeon, and the transplant can go ahead as soon as the organ arrives. I am no longer on-call as the next scientist takes over at 08:00, meaning I can now head home and catch up on my sleep!
• The NHS aspires to put the patient at the heart of everything we do. This is important, so much so that it forms one of the principles of the NHS constitution. Keeping this in mind, and being part of a good team, help make this job worthwhile, especially when working long hours or on short sleep.
• Every day is different. There are numerous different roles and tests to perform in the laboratory, and we are able to rotate every week. If we are on-call during the week, we also get some downtime to allow us to catch up on any sleep missed. This means that we do need to cover for other scientists at short notice, but ensures that we are never bored and always kept on our toes!
• Autonomous working. We are able to plan our own workload every week, which gives us time to carry out other activities. As state-registered scientists, we continuously need to show evidence of professional development to keep our registration up-to-date, as the field is constantly changing and new methods are implemented.
Have you got a story to share? Sign up to share your story below👇
Wondering what to read next? How about ‘Here’s what it’s like to be an Occupational Therapy student on placement’ 👇