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HLA antibody Testing

lab technician

Both cell based and solid phase immunoassays are used to determine if patients are sensitized to HLA antigens, to determine the strength and specificity of HLA antibodies and to determine the strength of reactivity with specific donors. In addition to antibodies to HLA antigens, the laboratory performs test for antibodies to antigens expressed on endothelial cells, angiotensin II type 1 receptor, vimentin and endothelin. Information from these assays is used to identify unacceptable antigens for patients awaiting deceased donor transplantation or transplantation via kidney paired donation, determine the best course of transplantation for sensitized patients, monitor donor-specific antibodies in patients undergoing desensitization and help identify the cause of allograft dysfunction. 

Solid Phase Immunoassays 

Screen, Phenotype and Single Antigen bead assays

Multi-analyte bead assays performed on the Luminex® platform are used to detect and characterize the presence of IgG, HLA class I- and class II-specific antibodies. Luminex®-based assays are performed using pooled antigen, phenotype and single antigen panels.

Crossmatch Tests

Crossmatch tests provide a direct assessment of the strength of donor-reactive antibody. Cytotoxicity crossmatch tests are performed on T lymphocytes using the antiglobulin-enhanced method and on B lymphocytes using a one wash method.

Flow cytometric crossmatch tests are performed for patients with antibody to donor HLA that is below the level of a cytotoxicity crossmatch. The test is a three-color fluorescent assay performed on a Becton-Dickinson Canto cytometer.