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Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, individual antigen per bead methodology), HLA Class II

CPT4 code

Name of the Procedure:

Antibody to human leukocyte antigens (HLA), solid phase assays (e.g., microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities, HLA Class II

  • Common Name: HLA Antibody Testing
  • Technical Term: HLA Class II Antibody Identification Assay

Summary

HLA antibody testing involves analyzing a patient's blood sample to identify specific antibodies against human leukocyte antigens (HLA). These antibodies are detected through advanced laboratory techniques that use microspheres, beads, ELISA, or flow cytometry.

Purpose

  • Addressing the risk of transplant rejection by identifying antibodies that could attack a donated organ.
  • Guiding treatment decisions for conditions like autoimmune diseases.
  • Improving compatibility assessment between donors and recipients in organ or tissue transplantation.

Indications

  • People being evaluated for organ or tissue transplantation.
  • Patients with a history of transplant rejection.
  • Individuals with autoimmune diseases or certain unexplained immune reactions.
  • Patients preparing for treatments such as stem cell therapy.

    Preparation

  • No special preparation is usually required.
  • Patients should inform their healthcare provider about any medications they are taking.
  • A blood sample is typically taken (fasting is not necessary unless specified by the doctor).

Procedure Description

  1. Blood Sample Collection: A small amount of blood is drawn from a vein in the arm.
  2. Laboratory Processing: The blood sample is sent to a lab where the serum is separated.
  3. Assay Execution:
    • In microsphere/beads and ELISA methods, the serum is exposed to HLA-coated beads or plates to detect binding antibodies.
    • Flow cytometry involves labeling antibodies with fluorescent markers to analyze them in a specialized machine.
  4. Data Analysis: The presence and specificity of antibodies are identified and recorded for further clinical decision-making.

Duration

The blood draw takes about 10-15 minutes. Laboratory analysis can take several hours to a few days to complete.

Setting

The blood sample is usually drawn in a clinic, doctor's office, or hospital. The analysis itself is performed in a specialized laboratory.

Personnel

  • Phlebotomist or nurse to collect the blood sample.
  • Lab technicians and medical technologists to analyze the sample.
  • Pathologists or immunologists to interpret the results.

Risks and Complications

  • Common Risks: Minor pain or bruising at the blood draw site.
  • Rare Risks: Infection or excessive bleeding at the draw site.

Benefits

  • Expected Benefits:
    • Precise identification of HLA antibodies.
    • Enhanced matching between organ/tissue donors and recipients.
    • Improved outcomes and reduced risk of transplant rejection.
  • Realization Time: Results contribute immediately to clinical decisions once analysis is complete.

Recovery

  • Post-Procedure Care: Minimal care required at the blood draw site (e.g., applying pressure, keeping the site clean).
  • Recovery Time: Immediate; no downtime required.
  • Restrictions: None, unless other tests or treatments are scheduled.

Alternatives

  • Other Options:
    • Cellular assays (e.g., complement-dependent cytotoxicity assays)
    • Crossmatch tests between donor and recipient tissue samples.
  • Comparison: Alternative tests may be less precise or slower, but can still provide useful information in different clinical contexts.

Patient Experience

  • During the Procedure: The patient will experience a brief pinch or sting from the needle during blood draw.
  • After the Procedure: Slight tenderness or bruising at the puncture site; easily manageable with over-the-counter pain relief if necessary. Comfort measures such as applying a cold pack to reduce any swelling.

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