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2005, Number 2

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Rev Invest Clin 2005; 57 (2)

Histocompatibility laboratory in organ transplantation program

de-Leo-Cervantes C
Full text How to cite this article

Language: Spanish
References: 11
Page: 142-146
PDF size: 56.88 Kb.


Key words:

Human leucosyte antigens (HLA), Panel reactive antibody (PRA).

ABSTRACT

The importance of the role of the histocompatibility laboratory in solid organ transplantation is to perform HLA typing and determine the degree of HLA matching between recipient/donor. It is a useful tool to increase graft survival and decrease chronic rejection. HLA matching has a positive effect on kidney transplants and it has variable impact on other organ transplants. The crossmatch procedure is the most important test in a solid organ transplantation to evaluate the presence of recipient antibodies to antigens expressed on donor white cells. This test decreases the risk of hyperacute humoral rejection or early graft loss. Positive crossmatch is a contraindication for transplantation because it represents the existence of IgG recipient antibodies that will reath againts donor antigens. Antibody evaluation is important in donor-recipient selection and the responsability of the histocompatibility laboratory is to identify clinically relevant anti-donor HLA antibodies. This detection is useful to determine the degree of humoral alloimmunization, expressed as a percent panel reactive antibody (%PRA). This test also provides information about the antibody specificity and can be used for evaluate a patient’s immune status providing a significant correlation in selecting donors.


REFERENCES

  1. Küss R, Bourget P. An Illustrated history of organ transplantation. The great adventure of the century. France: Laboratories Sandoz, Rueil Malmaison; 1992, p. 36.

  2. Dausset J. The HLA adventure. In History of HLA: Ten recollections. (ed. Terasaki PI). Los Angeles, CA: UCLA Tissue Typing Laboratory; 1990, p. 3-17.

  3. Tanabe K, Takahashi K, et al. Long-Term results of ABO-Incompatible living kidney transplantation. Transplantation 1998; 65: 224-8.

  4. Lechler R, Warrens A. HLA in health and disease (2a. ed.). London: Academic Press; 2000, p. 73-99.

  5. ASHI Laboratory Manual, American Society for Histocompatibility and Immunogenetics (4a. ed.). Lenexa, KS; 2000.

  6. Bunce M, Young NT. Molecular HLA typing-the brave New World. Transplantation 1997; 64: 1505-13.

  7. Cicciarelli JC. HLA typing immunogenetics and transplantation. Cur Op Org Transplant 2004; 9: 1-7.

  8. Gebel HM, Bray RA, et al. Pre-transplant assessment of donor-reactive, HLA-specific antibodies in renal transplantation: Contraindication vs. Risk. Am J Transplant 2003; 3(12): 1488-1500.

  9. Goggind R, Geiselhart L. Antibody screening beyond tears. ASHI Quarterly 2003; 27(2): 70-4.

  10. Hubbell C, Kamoun M, et al. Guideline for the development of joint written agreements between histocompatibility laboratories and transplant programs. ASHI Quarterly 2004; 28(3): 96-8.

  11. Opelz G, Wujciak B, et al. HLA compatibility and organ transplant survival. Collaborative transplant study. Rev Immunogenetics 1999; 1: 334-42.




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Rev Invest Clin. 2005;57