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HLA Testing Services

Engraftment Monitoring (Chimerism Testing)

The transplant engraftment monitoring (chimerism) test evaluates the success of a hematopoietic stem cell transplant by measuring the relative ratio of the recipient and the donor cell population in the recipient's post-transplant specimen. Engraftment monitoring test provides important information on the progress of donor engraftment following allogeneic stem cell transplant. Additionally, enriched cell sub-populations can be used to monitor engraftment of various cell types. Our current panel routinely includes cell markers CD3 and CD33. Additional markers including CD4, CD8, CD19 and CD56 are available upon request.

Clinical Utility:

The success of allogeneic stem cell transplantation is often affected by relapse or graft rejection. Monitoring of hematopoietic chimerism by PCR is a reliable and quantitative method for assessing successful engraftment or recurrent disease in recipients following allogeneic stem cell transplantation. Frequent post-transplant monitoring is used in the clinical setting to help in the diagnosis of disease relapse and graft failure and to promote treatment strategies that induce stable mixed chimerism.

Method:

The test is based on detection and comparison of DNA short tandem repeat (STR) regions in the recipient and donor after transplantation. STRs are highly polymorphic DNA sequences in the human genome. KCL performs engraftment monitoring by amplifying polymorphic STR markers using PCR and analyzing the PCR products by capillary electrophoresis. The test detects differences in allele types (the length of the repeats) between the donor and recipient cells at several STR loci. The most informative short tandem repeats are used to differentiate and quantify donor and recipient components in the post-transplant sample. Cell populations are prepared using monoclonal antibody coated magnetic beads.

Specimen Requirements:

Pre-transplant (Recipient and Donor)    
One 5-mL EDTA (purple top) tube of whole blood
OR 4 buccal swab (click here for instructions)
Post-transplant
Without Cell Enrichment (Recipient)    
One 5-mL EDTA (purple top) tube of whole blood or bone marrow
Post-transplant
With Cell Enrichment (Recipient)
Three 5-mL EDTA (purple top) tube of whole blood or bone marrow

If pre-transplantation testing was NOT performed by Kashi Clinical Laboratories, the following specimens are required:

Recipient: buccal swabs from the recipient may be submitted to serve as a substitute for pre-transplantation blood samples. Alternatively, a sample of pre-transplant extracted DNA may be submitted.

Donor: One 5-mL EDTA (purple top) tube from the donor. After the first post-transplantation test, no additional samples are required from the donor.

Shipping Requirements:

Samples are accepted Monday through Friday. Overnight shipments should be sent Monday through Thursday. Please overnight samples, at room temperature, along with the completed test requisition to:

Kashi Clinical Laboratories, Inc.
Attention: HLA Laboratory
10101 SW Barbur Blvd, Suite 200
Portland, OR 97219