Laboratory Test Information Guide

Details for HLA Antibody Testing

Test Name: HLA Antibody Testing
Alternate Name(s): PRA (Panel Reactive Antibodies)
HLA Monthly Serum
HLA Antibody Screen
HLA Antibody Specificity Testing

Cytotoxic Antibodies (this is largely an obsolete term since most testing is now based on solid phase beads rather than cellular panels)
Laboratory: Transplant (UH)
Specimen Type: 6 mL Red top Vacutainer tube - No additives or separator gel
Collection Information: Draw by venipuncture and pre-dialysis (if applicable) to avoid contamination with anticoagulants.

Routine samples for patients on the Kidney Transplant List should be drawn and shipped on the Monday and Tuesday of the 3rd week of the month.


Cerner Codes:
HLA Antibody Testing or HLA Transfusion Refractory (anti-HLA IgG)

The HLA Antibody Testing test is also part of several Care Sets and does not need to be ordered separately when one of the following is ordered:
HLA Serum for Crossmatch LD – Recipient
HLA Serum Pre-op – Recipient
Requisition: HLA Antibody Investigation Requisition
Test Schedule: The test is performed 3 times / week (MWF).
Some samples will be archived for possible testing at a later date. The status of the patient on a transplant waiting list dictates when/if the sample will be tested.
Turnaround time from when specimen
is received in testing laboratory:
 
Routine
See test schedule
Stat
Same day if the sample is received in the Transplant Laboratory before 0900 on MWF except Stats
 
Reference Range: PRAs: 0-100%

Specificity testing: usually the results will indicate if any antibodies were detected. In some cases, the detected antibodies may be listed.
Effective Date: 2006-07-07
Revised Date: 2012-10-15
Critical Value: N/A
Interpretive Comments: Antibodies directed against HLA antigens indicate sensitization to potential organ donors and some blood products and may predict risk of rejection and length of time on the waiting list.
Special Processing: Draw by venipuncture and pre-dialysis (if applicable) to avoid contamination with anticoagulants.
Comments: This test should be ordered only for patients on a London solid organ transplant waiting list. Contact the Transplant Laboratory to discuss other situations.

All patients that are active (or will soon be active) on the LHSC kidney waiting list should have this test ordered monthly since the sample will also be used for crossmatching potential donors.

In addition, antibody “specificities” will be investigated. Testing intervals are determined by the transplant program.
Method of Analysis: The standard method is solid phase bead technology using the Luminex® platform.

On rare occasions the method is microlymphocytotoxicity using techniques of enhanced sensitivity (AHG &/or extended incubation).
Critical Information Required: Indicate if the patient is undergoing therapy with products or medication containing human antibodies such as OKT3, IVIG, ALG etc. as these may interfere with the results.

Also indicate if the patient is undergoing a change in immunosuppression regime or is being treated by plasma exchange since these actions may explain fluctuations in results.
Storage & Shipment: Samples that are to be received within 24 hours are to be stored and shipped refrigerated. Samples that are delayed beyond 24 hours are to have the serum separated, frozen and shipped on dry ice (or frozen ice packs, if dry ice is not available).
System Codes: 
Cerner
See Collection Information
 
Referred To:  

Questions? Comments? Contact Laura Gopaul