Name of the Procedure:

HLA Class I and II Typing, High Resolution (HLA-A, -B, -C, and -DRB1)

Summary

HLA typing is a laboratory procedure used to determine the specific genetic markers (HLA alleles) in a person's immune system. This high-resolution typing helps in identifying specific alleles or allele groups for genes HLA-A, HLA-B, HLA-C, and HLA-DRB1.

Purpose

HLA typing is crucial for identifying compatible donors and recipients in organ and bone marrow transplants, ensuring a match that can reduce the risk of transplant rejection. It is also utilized in autoimmune disease studies, pharmacogenetics, and anthropological research.

Indications

This procedure is indicated for patients who:

• Are candidates for organ or bone marrow transplantation.
• Require donor matching for hematopoietic stem cell transplantation.
• Have certain autoimmune disorders or conditions that may benefit from immunogenetic research.
• Are participating in certain clinical trials.

Preparation

• No specific fasting or medication adjustments are generally required.
• Patients may need to provide a blood sample or buccal (cheek) swab.
• Inform the healthcare provider of any medications or conditions that might affect blood draws.

Procedure Description

1. A sample of the patient’s blood or a buccal swab is collected.
2. DNA is extracted from the sample.
3. Polymerase chain reaction (PCR) is used to amplify the HLA genes.
4. Next-generation sequencing or other high-resolution typing methods are employed to determine the precise HLA alleles present.
5. The alleles are then analyzed and compared to known HLA allele databases to identify specific genetic markers.

Tools and technology include PCR machines, sequencing technology, and bioinformatics software. Anesthesia or sedation is not required.

Duration

The entire process, from sample collection to final report, typically takes about 1 to 2 weeks, although the sample collection itself only takes a few minutes.

Setting

Sample collection can be done in a hospital, outpatient clinic, or specialized laboratory.

Personnel

• Laboratory technicians and clinical scientists are involved in the analysis.
• Nurses or phlebotomists might collect the sample.

Risks and Complications

• Slight discomfort or bruising at the blood draw site.
• Very low risk of infection or bleeding from the sample collection process.

Benefits

• Accurate donor-recipient matching can significantly reduce the risk of transplant rejection.
• Timely and precise diagnosis can lead to better management of autoimmune conditions.
• Access to personalized medicine approaches and relevant clinical trials.

Recovery

• No downtime or recovery period is required following sample collection.
• Normal activities can be resumed immediately after the sample is taken.

Alternatives

• Low-resolution HLA typing is available, but offers less detailed information, increasing the risk of mismatches.
• Serological typing methods, though less accurate than DNA-based methods.

Patient Experience

• The patient may experience slight discomfort during blood draw or swab collection.
• No significant pain or prolonged discomfort is expected.
• Results are discussed with the healthcare provider once available.