Name of the Procedure:

HLA Class I and II Typing, Low Resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing)

Summary

Human Leukocyte Antigen (HLA) typing is a lab test that identifies certain proteins (antigens) on the surface of cells. Low-resolution HLA typing, particularly for HLA-A, -B, and -DRB1, provides a broad match of these proteins to help ensure compatibility between organ or bone marrow donors and recipients.

Purpose

HLA typing is primarily used to ensure that a donor's and recipient's tissues are compatible for transplants, reducing the risk of graft rejection. It is also helpful in diagnosing certain autoimmune diseases and managing treatments accordingly.

Indications

• Organ or bone marrow transplantation
• Suspected autoimmune diseases (e.g., celiac disease, rheumatoid arthritis)
• Certain blood disorders requiring tissue matching
• Patients needing verification typing post-transplant

Preparation

• No specific fasting or major dietary adjustments required.
• Inform the doctor of all medications and supplements being taken.
• Blood samples are usually required; patients should be prepared for a blood draw.
• Previous diagnostic tests or medical records may be reviewed.

Procedure Description

1. Blood Sample Collection: Blood is drawn from a vein, typically in the arm.
2. Laboratory Analysis: The blood sample is sent to a lab where DNA is extracted.
3. HLA Typing: Molecular techniques like PCR (Polymerase Chain Reaction) are used to determine the HLA antigens present.
4. Verification: The results are compared against donor or recipient profiles to check for compatibility.

Duration

• Blood draw: Approximately 10-15 minutes.
• Lab analysis: Several hours to a few days, depending on the lab's workload and methods used.

Setting

Typically performed in outpatient clinics, hospitals, or specialized labs.

Personnel

• Phlebotomist for blood draw
• Laboratory technicians for sample analysis
• Medical doctor or specialist in transplantation or immunology interpreting the results

Risks and Complications

• Minor pain or bruising at the blood draw site
• Rare risk of infection at the puncture site
• Potential for a delayed or inconclusive result requiring a repeat test

Benefits

• Ensures better compatibility for transplants, thus reducing rejection risks.
• Assists in diagnosing and managing autoimmune diseases.
• Helps in effective post-transplant monitoring and treatment adjustments.

Recovery

• Minimal recovery needed from the blood draw.
• Patients can resume normal activities immediately after.
• Follow-up based on results, particularly if further medical procedures or treatments are necessary.

Alternatives

• High-resolution HLA typing, which provides more detailed matching but is more time-consuming and expensive.
• Serological HLA typing, less commonly used but another method for identifying HLA antigens.
• Autologous transplant, where the patient’s own cells are used (eliminates need for matching, but suitable only in specific conditions).

Patient Experience

• Mild discomfort during the blood draw.
• Minimal after-effects; slight soreness at puncture site is possible.
• Patients can generally drive themselves home and resume daily activities right away.
• Anxiety regarding the compatibility results and further treatment decisions may be managed through detailed discussions with healthcare providers.