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Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure)

CPT4 code

Name of the Procedure:

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

Summary

An HLA crossmatch, non-cytotoxic, using flow cytometry is a laboratory test used to determine compatibility between a donor and recipient in organ transplantation. It involves testing additional serum samples or diluted samples to ensure accurate results.

Purpose

The procedure is primarily used to ensure that the recipient's immune system will not reject the transplanted organ. The goal is to anticipate and prevent organ rejection by identifying potential immune system incompatibilities.

Indications

  • Pre-transplant evaluation for kidney, heart, lung, liver, or other organ transplants
  • Assessing donor-recipient compatibility
  • Identifying potential immune responses that could lead to transplant rejection

Preparation

  • No fasting or special dietary restrictions required.
  • Ongoing medications should be discussed with the healthcare provider.
  • Blood samples are collected from both the donor and recipient before the procedure.

Procedure Description

  1. Additional serum samples or diluted samples from the recipient are prepared.
  2. The recipient's serum is mixed with donor cells.
  3. Using flow cytometry, specific markers on the donor cells are identified to detect any antibodies in the recipient's serum that might react against the donor's tissues.
  4. Results are analyzed to determine compatibility.

Tools and Technology:

  • Flow cytometer
  • Tubes and reagents for serum sample preparation

Anesthesia or Sedation: Not applicable.

Duration

Approximately 1-2 hours for additional serum sample analyses.

Setting

The procedure is performed in a specialized laboratory setting.

Personnel

  • Laboratory technologists
  • Immunologists
  • Transplant coordinators

Risks and Complications

  • Minimal risks as it is a laboratory-based test.
  • Possible bruising or discomfort from blood sample collection.

Benefits

  • Increased likelihood of transplant success by preventing immune system rejection.
  • More precise identification of donor-recipient compatibility.
  • Faster and more comprehensive assessment compared to traditional methods.

Recovery

  • No specific recovery needed as this is a blood test.
  • Follow-up with the healthcare provider for results and next steps.

Alternatives

  • Traditional cytotoxic HLA crossmatching.
    • Pros: Well-established, widely used.
    • Cons: Can be less sensitive and slower than flow cytometry.

Patient Experience

  • Minimal discomfort during blood sample collection.
  • No pain or significant discomfort associated with the laboratory testing itself.
  • Results and next steps discussed in follow-up appointments with the healthcare provider.

Medical Policies and Guidelines for Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure)

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