Dr David Turner, Consultant Clinical Scientist in Histocompatibility and Immunogenetics
Each year, around 5,000 organ transplants and 17,002 bone marrow transplants give those with severe illnesses a chance at a new life. These transplants would be impossible were it not for the work of scientists in histocompatibility and immunogenetics – otherwise known as H&I. We speak to David Turner about his work in this specialty.
I have stayed with H&I, and enjoy my work immensely, because of the variety of activities that go with the job and the chance to work in an area of clinical science with such tangible benefits to patients. Whether a transplant proceeds or not, from an immunological risk perspective, is one of the key decisions we help our clinical colleagues to make.
Can you tell us what Histocompatibility and Immunogenetics is?
H&I is a life science laboratory discipline which is mainly involved in supporting safe and effective transplantation of organs, tissues and cells. There are around 25 H&I laboratories around the UK, providing testing of patients and donors to ensure transplantation of organs such as kidneys and hearts are compatible and therefore unlikely to be rejected by recipients. The field is also important in haematopoietic stem cell transplantation, which is a therapy provided to patients with leukemia and other bone marrow disorders, with H&I labs helping clinicians to identify the best matched donor for their patient. The main area of testing involves a group of variable proteins called Human Leukocyte Antigens (HLA) which are expressed on all cells and are central to the immune system being able to distinguish self from non-self. The job of the H&I scientist is to investigate these HLA variants in patients and donors to optimise transplantation and some specialist transfusions. Some HLA alleles are also relevant in diagnosis of autoimmune disease and predicting adverse drug reactions and this forms another large area of workload for H&I labs.
Can you tell us about your average working day?
As a Consultant Clinical Scientist in any discipline the work is broad and varied; from clinical liaison, R&D and presenting and publishing data to budget management, Quality aspects and health and safety. The most interesting and stimulating parts of the day involve assessing data generated in the lab and discussing its relevance with clinical colleagues, often at multidisciplinary team meetings. This kind of interaction happens regularly but the nature of the transplantation process, where certain activity can only occur when deceased donors are available, means that the work of H&I scientists can often occur overnight or at weekends, requiring a great deal of commitment from staff.
What kind of work does your job involve?
The various aspects of the job of a senior Clinical Scientist can broadly be grouped into the following categories: Clinical, Scientific and Professional. Clinical work involves close interaction with other healthcare professionals to ensure that data is understood and interpreted correctly to provide the best treatment for patients. To be able to correctly interpret and understand the relevance of data, Clinical Scientists require a strong Scientific understanding of their specialty and therefore ongoing development (continuous professional development (CPD)) is key to maintaining Scientific knowledge. This is achieved through attendance at conferences/webinars as well as publishing work relating to the departments own R&D interests. More broadly senior healthcare scientists also have a responsibility to ensure the lab they help to manage is compliant with guidelines, standards and regulations pertaining to the tests undertaken and staff welfare. This Professional area of the work involves regular self-audits and accreditation inspections which need to be prepared for and managed.
Why did you choose this specialty?
This might not be the best question for me to answer as in truth I have never worked in any other field! After graduating with a degree in Biochemistry I was offered a Clinical Scientist training post in H&I and, pretty much, that’s been my career ever since. I suppose that I have stayed with H&I, and enjoy my work immensely, because of the variety of activities that go with the job and the chance to work in an area of clinical science with such tangible benefits to patients. Whether a transplant proceeds or not, from an immunological risk perspective, is one of the key decisions we help our clinical colleagues to make. In addition, the fact that H&I is a relatively small discipline means that there is genuine camaraderie between labs in the UK. This translates into a very active professional society (the British Society for H&I) and allows great opportunities for networking, collaborative working and R&D. Certainly for myself, the friendships I have developed through professional activities are a key part of what working in H&I is all about.
What do you enjoy most about your chosen specialty?
As described above, the close interaction with our clinical colleagues and the feeling of being part of the team making decisions regarding transplantation and transfusion is one of the most rewarding elements of H&I. Also, there is a great deal of work ongoing in the UK, Europe and internationally to develop the discipline of H&I; it still feels like an area of science where new breakthroughs can occur which will improve outcomes for patients. An exciting future area for H&I is in the expertise we can bring to new cellular and vaccine treatments for cancer, where knowledge of the patient’s HLA ‘tissue type’ will be important to tailor therapies.
What do you find most rewarding about the role?
Perhaps during the middle of a busy week of meetings and report signing it might be possible to overlook the important work that all Healthcare Scientists do to ensure the correct diagnoses and treatment decisions are made for patients. Taking stock and thinking about the patients that have been helped because of the work undertaken in the lab is important and I know that everyone working in my lab feels that this patient focus is the most rewarding part of the work.
What advice would you give to students looking to enter your field?
H&I is a small discipline, but has a very active structure for training of staff coming into the field. If possible, try to visit your local H&I laboratory to discuss with staff what their job entails and hear about different routes into the lab. The Scientific Training Programme (STP) recruits graduates into many different scientific disciplines including H&I; more information can be found at NHS Scientist Training Programme | Health Careers.