86825 Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution

Name of the Procedure:

Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (e.g., using flow cytometry); first serum sample or dilution

Summary

The HLA crossmatch is a laboratory test performed to ensure compatibility between a donor and recipient's tissues before organ transplantation. This specific procedure uses flow cytometry to detect possible immune reactions between the recipient's serum and the donor's white blood cells.

Purpose

HLA crossmatch aims to prevent organ rejection in transplant recipients. The test identifies potential immune responses that could lead to complications if the donor organ is not compatible with the recipient's immune system.

Indications

• Candidates for organ transplantation (e.g., kidney, liver, heart).
• Sensitization status assessment in recipients awaiting transplants.
• Re-evaluation of transplant candidates after sensitization events (e.g., blood transfusions, pregnancy).

Preparation

• No fasting required.
• Patients may need to provide a blood sample prior to the procedure.
• Inform medical staff of any recent infections or vaccinations.
• Ensure that all relevant medical history, especially regarding previous transfusions and transplantations, is up-to-date.

Procedure Description

1. Blood Sample Collection: The patient's blood is drawn to obtain the first serum sample.
2. Serum Processing: The serum is separated from the blood cells.
3. Donor Cells Preparation: Donor's white blood cells are isolated.
4. Flow Cytometry Setup: The patient's serum is mixed with the donor's cells along with fluorescent markers.
5. Analysis: Flow cytometry equipment analyzes the mixture to detect any antibody binding, indicating possible incompatibility.

Tools: Flow cytometer, fluorescent markers, isolation equipment for serum and white blood cells.

Duration

Typically takes a few hours from sample collection to analysis.

Setting

Performed in a specialized laboratory within a hospital or clinic.

Personnel

• Medical Technologists
• Pathologists
• Laboratory Technicians

Risks and Complications

• Minimal risks as it is a non-invasive test.
• Rarely, incorrect results may lead to improper donor-recipient pairing.
• Minor discomfort during blood sample collection.

Benefits

• Helps prevent organ rejection.
• Enhances the success rate of organ transplantation.
• Results are usually available within a few hours to a day.

Recovery

• No specific recovery process required.
• Patients can resume normal activities immediately after blood sample collection.
• Follow-up with transplant team for further steps.

Alternatives

• Complement-dependent cytotoxic crossmatch.
  • Pros: Standard technique, widely used.
  • Cons: May be less sensitive than flow cytometry.
• Virtual crossmatch.
  • Pros: Non-invasive, uses existing data.
  • Cons: May not be as accurate in real-time sensitization status.

Patient Experience

• Patients may feel slight discomfort or pain during blood sample collection.
• No significant pain or side effects expected from the procedure itself.
• Overall, it is a straightforward and non-intimidating process.