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HLA Testing Services

HLA Antibody Testing

Patients may become sensitized to HLA antigens through pregnancies, blood transfusions or transplantations and develop HLA antibodies. The presence of these pre-formed anti-HLA antibodies may lead to acute or chronic graft rejection or failed platelet transfusion. When present in blood donors, HLA antibodies may passively transfer to recipients and lead to development of transfusion-related acute lung injury (TRALI). HLA antibodies can be identified and characterized using various techniques.

Clinical Utility:

Antibody Screening and Identification: Patients facing transplant surgery or platelet transfusion need to be tested for the presence of anti-HLA antibodies. HLA Class I and Class II antibody screening and identification tests are performed to help identify the most compatible donors for a patient in need of platelet transfusion or transplantation who may have developed allogeneic HLA antibodies. In addition, these tests help clinicians to monitor the patient’s post-transplant/transfusion immune status for therapeutic purposes.

Antibody Screening: HLA Class I and Class II antibody screening is also used in testing plasma samples from the implicated blood donors and patients for leukocyte antibodies in evaluation of a suspected TRALI case. In addition, blood donors known to be leukocyte-alloimmunized or at increased risk of leukocyte alloimmunization are tested for HLA antibodies.

Method:

Antibody Identification: The Single Antigen assay is used for the confirmation of antibody specificity suggested by a previous PRA test. Microbeads coated with purified Class I or Class II HLA antigens is used to detect HLA antibodies present in the test serum that will bind to the antigens on these beads. The reaction pattern of the test serum is detected fluorescently using a flow analyzer.

Antibody Screening: The laboratory uses a panel of color-coded microspheres coated with purified HLA antibodies to determine percent reactivity of antibodies present in tested plasma.  Test serum or plasma is first incubated with these coated beads. Any HLA antibodies present in the test serum bind to the antigens on the beads and will be detected fluorescently using a flow analyzer.

Specimen Requirements:

Any of the following specimens are acceptable for leukocyte antibody testing:

One 5-mL EDTA (purple top) or ACD (yellow top) tube
- sent overnight at room temperature
One clot (red top) tube
- sent overnight at room temperature
Separated serum (from clotted samples) or plasma (in ACD or K-EDTA) refrigerated up to 5 days
- sent overnight on wet or dry ice
Separated serum (from clotted samples) or plasma (in ACD or K-EDTA) frozen up to one year
- sent overnight on dry ice

Shipping Requirements:

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

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