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HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each

CPT4 code

Name of the Procedure:

HLA Class II Typing, High Resolution (e.g., Alleles or Allele Groups); One Allele or Allele Group (e.g., HLA-DQB1*06:02P)

Summary

HLA Class II Typing at high resolution is a genetic test that identifies specific variations in the Human Leukocyte Antigen (HLA) system, particularly focusing on alleles or allele groups within the HLA Class II region, such as HLA-DQB1*06:02P. This test is performed to provide a detailed match for organ and tissue transplantation and to understand genetic susceptibility to certain diseases.

Purpose

  • To match organ and tissue donors with recipients to minimize the risk of transplant rejection.
  • To help diagnose and understand the genetic basis of autoimmune disorders and other diseases linked to HLA variations.
  • The goal is to ensure better compatibility between donors and recipients in transplants and to tailor medical management of genetic conditions.

Indications

  • Patients needing organ or hematopoietic stem cell transplantation.
  • Individuals with suspected autoimmune diseases, like Type 1 diabetes or celiac disease.
  • Patients who have a family history of HLA-related conditions and need genetic investigation.

Preparation

  • Usually, no special preparation is required, but patients should inform their healthcare provider of any medications they are taking.
  • A blood sample might be needed, and patients may be instructed to stay hydrated or avoid certain foods based on lab-specific requirements.

Procedure Description

  1. Sample Collection: Typically, a blood sample is collected from the patient.
  2. DNA Extraction: DNA is extracted from the collected blood sample.
  3. PCR Amplification: Polymerase Chain Reaction (PCR) is used to amplify specific HLA regions.
  4. Sequencing: High-resolution sequencing methods, such as Next-Generation Sequencing (NGS), analyze the amplified DNA.
  5. Data Analysis: The results are interpreted using specialized software to identify specific HLA Class II alleles or allele groups.

Duration

The entire process from sample collection to results typically takes about one to two weeks.

Setting

The procedure is performed in a specialized laboratory setting, often connected to a hospital or independent diagnostic facility.

Personnel

  • A phlebotomist or nurse to collect the blood sample.
  • Laboratory technicians and geneticists to perform the analysis and interpret results.

Risks and Complications

  • Common Risks: Minor discomfort or bruising at the blood draw site.
  • Rare Risks: Infection at the puncture site or incorrect interpretation of genetic results. All risks are generally minimal and manageable.

Benefits

  • Increased chances of success in organ and tissue transplantation due to better donor-recipient matching.
  • Enhanced understanding and management of autoimmune disorders and other HLA-related conditions.
  • Quick turnaround for results, aiding in timely medical decision-making.

Recovery

  • No significant recovery process is needed as it is a non-invasive blood test.
  • Patients can resume normal activities immediately after sample collection.
  • Follow-up appointments may be scheduled to discuss the results and subsequent steps.

Alternatives

  • Low-Resolution HLA Typing: Less detailed compared to high resolution but quicker and less costly.
  • Serological Typing: Older method, less accurate than DNA-based high-resolution typing.
  • Each alternative has its own pros and cons in terms of accuracy, cost, and detail of information provided.

Patient Experience

  • The blood draw involves a quick needle stick, and some might feel minor discomfort or pain.
  • During the waiting period for results, patients should maintain normal activities unless instructed otherwise by their healthcare provider.
  • Upon receiving results, there may be discussions about the implications and next steps based on findings.

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