Our Transplant Immunology and Immunogenetics Laboratory offers complete tissue type testing (histocompatibility) using state-of-the-art technology and procedures for patients waiting for organ or hematopoietic stem cell transplants. The laboratory supports the following transplant programs in the pre-, peri-, and post-transplant settings: kidney/pancreas, pancreatic islet cell, liver, heart, lung, and hematopoietic stem cell. Additionally, the laboratory performs HLA testing for disease associations (such as celiac disease), drug hypersensitivity, and platelet transfusion support. 

Our pre-transplant patient and donor testing areas include initial and verification HLA typing for hematopoietic stem cell transplants, HLA verification typing of umbilical cords prior to transplant, HLA typing for solid organ transplants, HLA antibody testing for hematopoietic stem cell and solid organ transplants, and pre-transplant crossmatches for living-donor transplants. Also, the laboratory monitors HLA antibodies over time for patients on the deceased donor waitlist.

Our peri-transplant testing areas include pre-transplant crossmatches for living-donor transplant, retrospective crossmatch for thoracic organ and liver transplants, and virtual crossmatch performance for solid-organ transplant patients.

Post-transplant testing services include routine monitoring of donor-specific HLA antibodies for early signs of rejection which provide physicians valuable information to assist with managing treatment for patients who have had transplants. We also support the transplant programs with donor selection, compatibility assessment, interpretation of HLA testing due to interfering factors, and immunological risk.

Why is HLA testing performed at various stages in transplantation?

The identification of tissue histocompatibility antigens and genes of patients and potential donors is performed to assess the degree of match, the better the match, the lower the chance for harmful post-transplant immune reactions.

The detection and characterization of HLA-specific antibodies are performed to identify the presence of donor-specific-antibodies that could cause potential complications post-transplant.

Crossmatch testing for solid organ transplant patients is performed to determine if the patient has developed HLA antibodies specific to a potential donor.

Other areas of testing

Disease association:
Patients are HLA typed to determine if they carry genes known to be associated with certain diseases. These tests can help physicians diagnose and determine an appropriate treatment plan for their patients.

Drug hypersensitivity:
Several drugs are associated with severe reactions if administered to patients who carry specific HLA genes. HLA typing of patients before prescribing these drugs helps prevent potentially life-threatening reactions.

Platelet transfusion support:
Patients with low platelet counts are at risk of severe bleeding complications and are frequently transfused with healthy donor platelets. However, patients can sometimes produce antibodies to the HLA molecules expressed on platelets, which reduces the effectiveness of platelet transfusion. HLA typing and antibody detection help physicians choose a platelet donor that will increase platelet counts for patients in need.

Tests performed

• Flow cytometric antibody screen
• Luminex-based multiplexed antibody detection of HLA phenotypes
• Luminex-based single-antigen HLA antibody detection
• Complement-fixing HLA antibodies (C1q)
• Flow cytometric crossmatch against B and T cells
• Luminex-based molecular HLA typing
• High-resolution typing by next-generation-sequencing (NGS)

Laboratory Tests Performed

• HLA Antibody Testing
• HLA Donor-Specific Antibody
• HLA Class I High-Resolution Typing
• HLA Class I Low-Resolution Typing
• HLA Class II High-Resolution Typing
• HLA Class II Low-Resolution Typing
• HLA Disease-Associated / Single Antigen
• Celiac Disease HLA Testing

Transplant Work Ups

• Islet Cell Transplant Workup
• Kidney Transplant Recipient Workup
• Kidney Transplant Donor Workup
• Liver Transplant Workup
• Heart Transplant Workup
• Lung Transplant Workup
• Matched Platelet Workup
• Pre/Post Transplant Monitoring
• Stem Cell Initial Recipient HLA Typing
• Stem Cell Initial Donor HLA Typing
• Stem Cell Haplo Donor HLA Typing
• Stem Cell Verification HLA Typing
• Transplant Crossmatch: Initial
• Transplant Crossmatch: Final
• Transplant Crossmatch: Retrospective