Laboratory Test Information Guide

Details for HLA Assessment-Renal Recipient (for Kidney, Kidney/Pancreas, Pancreas alone or Liver/Kidney patients)

Test Name: HLA Assessment-Renal Recipient (for Kidney, Kidney/Pancreas, Pancreas alone or Liver/Kidney patients)
Alternate Name(s):  
Laboratory: Transplant
Specimen Type: 8 x 6mL dark Green (Sodium Heparin) top Vacutainer tubes without gel separator
2 x 4 mL Lavender (EDTA) top Vacutainer tubes
1 x 6mL Red top Vacutainer tube-No additives or separator gel
Collection Information: Draw by venipuncture and pre-dialysis (if applicable) to avoid contamination with anticoagulants.
HLA Recipient Assessments are performed only for patients in the London Transplant Program and must be booked in advance by calling the laboratory. (519-663-3320)
The patients are bled at the UH LTC or on the floor early in the morning and samples are delivered immediately to the Transplant Laboratory (room temperature) for same day test
Requisition: TRANSPLANT LABORATORY REQUISITION
Test Schedule: Monday to Friday
Turnaround time from when specimen
is received in testing laboratory:
 
Routine
14 days
Stat
Same day if blood is received in the laboratory before 0900
 
Reference Range: cPRAs: 0-100% (HLA Antibody Testing)

HLA Typing: see report

Autologous Crossmatch: Negative / Borderline / Positive
Effective Date: 2020-06-29
Revised Date:  
Critical Value:  
Interpretive Comments: Anti-HLA antibodies indicate sensitization to potential organ donors and some blood products. The cPRA is an indicator of how broadly anti-HLA antibody in the patient reacts to random donors. Elevated cPRA s may reflect a higher level of difficulty in finding an acceptable donor.

A positive autologous crossmatch indicates the likely presence of autologous antibodies. These antibodies may result in false positives when allogeneic crossmatches are performed.
Special Processing: Samples are tested when received. Sera and DNA are stored for possible future use.
Comments: Patients that are being assessed for placement on the LHSC Kidney, Kidney/Pancreas, Pancreas, Liver/Kidney waiting list should have this test ordered.
Patients will have Class I and Class II HLA Typing, cPRA and antibody specificities tested. Patient will also have an autologous flow crossmatch performed.
Method of Analysis: cPRA determinations are determined with the CBS cPRA calculator and are based on specificities detected with solid phase bead technology using the Luminex® platform.
HLA Class I and Class II typings are performed using molecular techniques (RSSO or SSP).
Autologous crossmatches are performed using flow cytometry.
Critical Information Required: Indicate if the patient is undergoing therapy with products or medication containing therapeutic antibodies such as Rituxan, Campath, Eculizumab, IVIG, OKT3, ALG, etc. as these may interfere with the results.

Indicate if the patient has had any sensitizing events such as blood transfusions, previous transplants, pregnancies etc. as these could influence the interpretation of 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 drawn at LHSC are delivered immediately to the Transplant Laboratory at room temperature.

Samples for Antibody Testing (1 red top) drawn outside of LHSC must be spun and the serum removed and frozen. Ship on dry ice if shipping requires >24 hours. Ship frozen on freezer packs if the sample will be received in < 24 hours.

Samples for HLA Typing (2 Lavender tops) drawn outside of LHSC must be shipped at room temperature

Samples for Autologous Crossmatching (8 green tops) drawn outside of LHSC must be shipped at room temperature and must be received by 09:00 next day delivery.
System Codes: 
Cerner
HLA Assessment-Renal Recipient
 
Referred To:  

Questions? Comments? Contact Laura Gopaul