Most patient workups performed in the HLA Laboratory involve more than one test.  Please refer to the following test profile description for sample requirements and test to be ordered.  For further assistance, please contact the HLA laboratory at (509) 232-4490.

New kidney patient workup

An initial workup for potential kidney transplant recipients consists of ABO typing, HLA Class I (ABC) typing and HLA Class II (DRDQ) typing.  New kidney patient workups are scheduled through the SHKTPR

Sample requirements:
1-10 ml plain red clot tube
4-10 ml ACD-A tubes

New heart patient workup 

An initial workup for potential heart transplant recipients consists of ABO typing, HLA Class I (ABC) typing, and HLA Class II (DRDQ) typing.  New heart patient workups are scheduled through the INTOTP.

Sample requirements:
1-10 ml plain red clot tube
4-10 ml ACD-A tubes

Preliminary deceased organ donor workup 

The initial workup for a deceased organ donor consists of ABO testing, HLA Class I (ABC) typing and HLA Class II (DRDQ) typing.  Test results are reported immediately to LCNW for allocation of donor organs.  Preliminary deceased organ donor workups are coordinated by LCNW.

Sample requirements are determined case by case.

Preliminary workup for potential living kidney donor(s) 

When a kidney transplant patient has potential living donors, the HLA lab performs ABO typing, HLA Class I (ABC) typing, and HLA Class II (DRDQ) typing on the patient and each potential donor.  Additionally, a cytotoxic lymphocyte crossmatch and flow cytometric lymphocyte crossmatch may be performed between the patient and each potential donor.  Preliminary living donor studies are scheduled through the SHKTP.

Sample requirements (for patient and donor):
1-10 ml plain red clot tube
5-10ml ACD-A tubes

Final crossmatch from living kidney donor 

Following the preliminary workup but prior to transplantation, a final crossmatch is performed between the kidney transplant recipient and their living donor.  The final crossmatch consists of ABO confirmation for patient and donor, cytotoxic lymphocyte crossmatch and flow cytometric lymphocyte crossmatch.  Final crossmatches from living donors are usually performed on the day before surgery and are scheduled through the SHKTP.

Patient sample requirements:
1-10 ml plain red clot tube
3-10 ml ACD-A tubes

Donor sample requirements:
1-10 ml plain red clot tube
4-10 ml ACD-A tubes

Final crossmatch from a deceased kidney/heart donor

For kidney and heart transplants, a final crossmatch is performed between the transplant patient and the deceased organ donor.  The final crossmatch consists of cytotoxic lymphocyte crossmatch and flow cytometric lymphocyte crossmatch.  Final crossmatches from a deceased organ donor are coordinated through LCNW and either SHKTP or INTOTP.

Patient sample requirements:
1-10 ml plain red clot tube
3-10 ml ACD-A tubes

Donor sample requirements:
1-10 ml plain red clot tube
2-3 lymph nodes OR spleen section

Antibody screening for heart transplant candidates

Patients awaiting a heart transplant will have antibody screening performed periodically.  If patients have received blood products, they will be screened weekly for at least six weeks following transfusion.  Testing involved in antibody screening can potentially include  FlowPRA I/II screen, and Luminex Single Antigen antibody identification.

Sample requirements:
1-10 ml plain red clot tube

Antibody screening for kidney transplant candidates

Patients awaiting a deceased donor kidney transplant must submit samples monthly for periodic antibody screening.  Tubes are sent to patients via mailing boxes and are returned to the HLA lab through the mail.  Testing involved in antibody screening can potentially include FlowPRA I/II screen, and Luminex Single Antigen antibody identification.

Sample requirements:
1-10 ml plain red clot tube

VAD patient workup

Patients receiving a ventricular assist device (VAD) as a bridge to transplant or as a destination therapy may have samples drawn for a FlowPRA I/II screen or Luminex Signle Antigen antibody identification.  VAD patient workups are coordinated through INTOTP.

Sample requirements:
1-10 ml plain red clot tube (for antibody testing)

Post-transplant antibody screening

Following transplantation, antibody screening may be performed in order to assess whether or not the patient is producing antibodies against the transplanted organ.  Testing involved in antibody screening can potentially include FlowPRA I/II screen, and Luminex Single Antigen antibody identification.

Sample requirements:
1-10 ml plain red clot tube

Initial workup for potentially refractory platelet patient

HLA antibody screening is performed in order to identify if a platelet recipient has become refractory due to antibodies against HLA antigens.  Luminex Single Antigen antibody identification is performed. If antibody screening is negative, the patient does not require HLA compatible platelets.  If antibody screening is positive, the patient may require HLA-compatible platelet transfusions.

Sample requirements:
1-10 ml plain red clot tube
1-10 ml ACD-A tube

Ongoing support for refractory platelet patient

If a patient serum is positive for HLA antibodies, HLA Class I (ABC) typing and Luminex Single Antigen anitbody identification may be performed to identify compatible platelet products.  An HLA compatible platelet donor search is performed to identify suitable donors.  Periodically, antibody screening may be repeated to detect newly developing antibodies.

Sample requirements:
1-10 ml plain red clot tube
1-10 ml ACD-A tube

HLA B27

The presence of HLA B27 has a high relative risk associated with the autoimmune disorder ankylosing spondylitis.  The HLA B27 test is a single antigen typing that can assist physicians in the diagnosis of this disease.  This test is performed by sequence-specific primer (SSP).

Sample requirements:
1-10 ml ACD-A tube

HLA typing or disease association testing

In addition to the test profiles listed, HLA typings may be performed for preliminary identification for donors for bone marrow or stem cell transplantation, vaccine study suitability, or other disease association.  An HLA Class I (ABC) typing and/or HLA Class II (DRDQ) typing can be performed as requested by the physician for complete or single antigen HLA typings.

Sample requirements:
1-10 ml ACD-A tube (HLA Class I (ABC) typing)
3-10 ml ACD-A tube (HLA Class II (DRDQ) typing)