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HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each

CPT4 code

Name of the Procedure:

HLA Class I Typing, High Resolution (Alleles or Allele Groups); One Locus (HLA-A, -B, or -C)

Summary

Human Leukocyte Antigen (HLA) Class I typing, high resolution, involves identifying specific genetic variations in one HLA locus (HLA-A, HLA-B, or HLA-C) using advanced molecular techniques to precisely determine an individual's HLA alleles.

Purpose

HLA typing is essential in organ transplantation, particularly for matching donors and recipients, to reduce the risk of transplant rejection. It also plays a role in diagnosing certain autoimmune diseases and tailoring medical treatments, including personalized medicine.

Indications

  • Organ or bone marrow transplantation: ensuring compatibility between donors and recipients.
  • Diagnosis and management of autoimmune diseases like ankylosing spondylitis or narcolepsy.
  • Certain immune-related conditions where HLA type influences the disease process or therapy outcomes.

Preparation

  • No special preparation like fasting is typically required.
  • Blood sample collection, which might necessitate preliminary blood tests.
  • Patients might be advised to inform the clinician about any medications or medical conditions.

Procedure Description

  1. A blood sample is collected from the patient, typically from the arm.
  2. The sample is sent to a specialized laboratory.
  3. DNA is extracted from the blood cells.
  4. Advanced molecular techniques, such as polymerase chain reaction (PCR) and sequencing, are used to identify and analyze the specific HLA alleles.
  5. Data is analyzed to provide a high-resolution report of the HLA locus typed (HLA-A, HLA-B, or HLA-C).

Duration

The blood draw takes about 10-15 minutes. The molecular testing and analysis can take several days to a week, depending on the lab's turnaround time.

Setting

The blood draw is conducted in a hospital, outpatient clinic, or specialized diagnostic center. The genetic analysis is performed in a laboratory equipped for molecular testing.

Personnel

  • Phlebotomist or nurse: Blood sample collection.
  • Lab technician or molecular biologist: Perform the genetic analysis.
  • Pathologist or geneticist: Interpret and report the results.

Risks and Complications

  • Minor risks associated with blood draw: bruising, slight pain, or infection at the puncture site.
  • No significant risks from the HLA typing itself.

Benefits

  • Enables precise matching for organ or bone marrow transplantation, significantly reducing rejection risk.
  • Aids in diagnosing and managing autoimmune diseases and other HLA-related conditions.
  • Facilitates personalized medicine strategies based on genetic makeup.

Recovery

  • Minimal recovery needed post blood draw.
  • Patients can resume normal activities immediately.
  • Follow-up based on the clinical context (e.g., transplantation planning or disease management).

Alternatives

  • Lower resolution HLA typing, which might be less precise but faster and more cost-effective.
  • Serological HLA typing, using antibodies to determine HLA types but with lower resolution compared to molecular methods.

Patient Experience

  • During the blood draw, patients may feel mild discomfort or a brief pinch.
  • Post-procedure, the site might be slightly sore or bruised but generally improves quickly.
  • No discomfort related to the HLA typing itself, as it involves laboratory analysis of the collected blood sample.

Medical Policies and Guidelines for HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each

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