The Leeds Teaching Hospitals NHS Trust

Pathology

Transplant Immunology Useful Information

Transplant Immunology Useful Information

Transplant Immunology Service Prospectus

 

Solid Organ Transplantation

HLA (Human Leukocyte Antigens) are expressed on the surface of cells and are involved in the recognition of self and non-self. They are used when matching solid organ transplant recipients with potential donors in accordance with the NHS-Blood and Transplant (NHS-BT) national allocation scheme. DNA is extracted from whole blood and transplant recipients and potential donors are typed for HLA Class I and Class II antigens. Recipients are also screened for HLA antibodies in their serum. Once all tests have been performed the laboratory will complete the appropriate parts of the NHS-BT registration form to register the recipient for a solid organ transplant.

Kidney Transplant Patient Information Leaflet 

Liver Transplant Patient Information Leaflet

Kidney Transplant Donor Information Leaflet

Liver Transplant Donor Information Leaflet

 

Haematopoietic Stem Cell Transplantation (HSCT)

Close matches at the DNA level for HLA typing are required for HSCT to minimise the chances of Graft vs Host Disease (GvHD). Patients are HLA typed to second field for Class I and Class II antigens using molecular techniques and are screened for HLA antibodies. Family donors are typed at Class I and if matched are Class II typed and ABO blood grouped. Volunteer Unrelated Donor (VUD) searches are only performed at the request of the HSCT Programme Director.

 HSCT Patient Information Leaflet

 HSCT Donor Information Leaflet

HLA Antibody Screening

Transplant recipients can form HLA antibodies in their serum following sensitising events like blood or blood product transfusion, solid organ transplantation and pregnancy. It is essential that patients on the NHS-BT transplant waiting list are monitored every 3 months, or following a potential sensitising event. All changes to the recipient sensitisation status are reported to NHS-BT by the laboratory.

 

Crossmatching

Crossmatching is a test performed prior to transplantation to exclude potential donors expressing HLA to which the recipient has formed antibodies. This minimises the risk of hyperacute rejection of the transplanted organ.

Disease and Drug Hypersensitivity Associations

Certain diseases or drug hypersensitivity conditions have been shown to have positive or negative association with certain HLA antigens or alleles. This is quantified as a relative risk. Results are reported as positive or negative for the associated allele. 

Disease Association Information Leaflet