WELCOME TO UCSD LABORATORY SERVICES GUIDE

# A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

GENERAL LABORATORY NOTES for IMMUNOGENETICS & TRANSPLANTATION

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General Sample Requirements:

     Each blood tube or individual container must be labeled with:

          - Patient's legal full name

          - At least one of the following identifiers:

                    Medical Record Number   

                    Date of Birth

                    Social Security Number

HIC Number

Reference ID Number

          - Draw Date / Time

          - Phlebotomist signature

All samples must be maintained at room temperature.  Do not refrigerate. 

 The laboratory can facilitate the testing of out of town patients by sending complete blood collection sets.

***SPECIMEN REQUIREMENTS:

RED TOP TUBES (10 ml):

     - Avoid hemolysis.

     -  Keep at room temperature - Do not refrigerate.

     - Serum separator tubes are not recommended.

     - Sample must be drawn pre-heparin.

ELISA – This technique is highly sensitive and specific for IgG HLA antibodies. Testing is available for both HLA Class I antibodies and HLA Class II antibodies. This technique is not complement dependent and is capable of detecting antibodies that are not cytotoxic. ELISA antibody testing is qualitative.

Cytotoxic (Extended Incubation) – This method is moderately sensitive of HLA Class I IgM and IgG antibodies. It is primarily useful for detecting IgM reactivity since this is not detectable with non-cytotoxic techniques and is not reliably detected with antihuman globulin (AHG). IgM antibodies are distinguished from IgG antibodies by treatmentment of the serum with dithiothreitol (DTT).

Cytotoxic (AHG) – This method is very sensitive for HLA Class I IgG antibodies. It may detect IgM as well, though it is not as reliable.

Flow Cytometry – This method is extremely sensitive for IgG antibodies and is used primarily to characterize reactivity detected in crossmatching which is not explainable by cytotoxic antibody testing. Flow Cytometric antibody testing utilizes purifed HLA antigens bound to beads for either screening or high definition antibody assays. Testing is available for both HLA Class I antibodies and HLA Class II antibodies.

It is recommended that prospective solid organ transplant recipients be tested: as a part of their initial histocompatibility workup, monthly until transplanted, and weekly for four weeks after any significant immunizing event. The Immunogentics and Transplantation Laboratory utilizes a multi-faceted approach of HLA antibody testing. Tthe testing can include one or all of the following tests: ELISA, Cytotoxic (Extended Incubation and\or AHG), and Flow. Each sample subsequent to the initial workup is reflexed based on the results from the previous sample tested.

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