The Immunogenetics (HLA) Laboratory provides support services to affiliated renal, pancreas, cardiac, and bone marrow transplant programs, and to the hematology/oncology clinics. Service is also provided to all other departments for HLA-associated disease studies, and to other laboratories requiring proof of identity through genetic markers. Laboratory testing includes HLA antigen and allele typing performed by PCR-based molecular methods; HLA antibody screening and identification by flow cytometry, bead array; HLA crossmatching of donor/recipient pairs by flow cytometry; and bone marrow engraftment studies (chimerism) by short tandem repeat (STR) analysis.
Antibodies are the effector products of the immune response to foreign substances. The detection of HLA antibodies is a critical component of a transplantation work-up as the presence of class I and/or class II HLA-specific antibody may cause rejection in the case of solid organs, or GVHD or perhaps failure to engraft in the case of hematopoietic stem cells. Crossmatch testing is performed to identify the presence of donor specific antibody against potential donors. The Laboratory presently uses state of the art flow cytometric assays to perform donor/recipient crossmatches, identify panel reactive antibody (PRA).
Antibody detection to HLA class I and II antigens is carried out by Luminex microbead array technology in the pretransplant setting to define unacceptable donor antigens and in the post transplant to detect donor specific (DSA) antibody; antibody identification is defined to humoral epitopes found in HLA alleles allowing a more detailed and concise understanding of patient’s humoral response to mismatched amino acids on transplanted foreign tissues. The Lab also separates lymphoid and myeloid cell populations from blood and marrow for establishing chimerism in these two cell populations, and establishes purity of the separations through flow cytometric analysis.
The HLA laboratory is staffed with a director, a supervisor, a senior group lead, two technical specialists, eleven technologists and two clerks. The laboratory is accredited to performed HLA tissue typing for HSC/BM Transplantation related and unrelated donor, solid organ transplantation live donor and histocompatibility testing for other clinical purposes such as disease association studies and pharmacogenetics.
Areas of accreditation:
HSC/BM Transplantation: Related Donor
HSC/BM Transplantation: Unrelated Donor
Solid Organ Transplantation: Live Donor
Histocompatibility Testing for Other Clinical Purposes.
Technologies and Methods Accredited for:
DNA Typing: Class I/II-Low-SSOP
KIR Typing: SSP
Crossmatching: T-cells/B-cells-Flow Cytometry
Antibody Screening Class I/II: ELISA, Microarrays
Antibody Identification Class I/II: CDC, ELISA, Microarrays