Laboratory Test Information Guide

Details for HLA Workup Deceased Donor

Test Name: HLA Workup Deceased Donor
Alternate Name(s): Deceased Donor HLA Typing and Deceased Donor Crossmatch
Laboratory: Transplant
Specimen Type: Adult Donor blood for a workup involving a kidney or kidney/pancreas transplant (+/- other organs):
10 x 8.5 mL ACD (Solution A) (yellow tops)*
2 x 4 mL Lavender EDTA top Vacutainer tube

Adult Donor blood for a workup involving a heart transplant only:
8 x 8.5 ml. ACD (Solution A) (yellow tops)*
1 x 4 mL Lavender EDTA top Vacutainer tube

Adult Donor blood for a workup involving a liver transplant only:
1 x 4 mL Lavender EDTA top Vacutainer tube

*Substitute 14 x 6 mL Sodium Heparin (dark green tops, no separator gel) Vacutainer tubes if ACD tubes are not available.

Pediatrics Donor blood for a workup involving the transplant of any organ(s) except a liver only:
Less than 1 year:
15 mLs ACD blood + 2 mL EDTA blood
1-10 years: 30 mLs ACD blood + 2 mL EDTA blood
11-18 years: 40 mLs ACD blood + 4 mL EDTA blood

Paediatric Donor blood for a workup involving a liver transplant only:
All ages:
2 to 4 ml. EDTA blood

NOTE: additional blood samples are required for testing unrelated to HLA i.e. ABO grouping, viral serology etc. Contact the donor coordinator or see the insert in the donor kits for details. Also see the collection information below.

NOTE: A small section of donor spleen (approx. 2 cm. X 2 cm.) or several lymph nodes are required at the time of organ retrieval.
Collection Information: Pre-packaged “kits” which include tubes and requisitions required for a deceased donor HLA workup are available from Client Support. Contact 519 685-8500 ext 56495 for details.

Some of the tubes in these kits are for tests performed in other laboratories. The SRA staff will distribute the samples to the appropriate areas.
Requisition: TRANSPLANT LABORATORY REQUISITION
Test Schedule: As required
Turnaround time from when specimen
is received in testing laboratory:
 
Routine
Retrospective crossmatching: end of the next working day
Stat
See Comments Section
 
Reference Range:  
Effective Date: 2020-06-29
Revised Date:  
Critical Value:  
Interpretive Comments: Anti-HLA antibodies indicate sensitization to potential organ donors and some blood products.

Antibodies directed against donor HLA antigens may predict risk of rejection

The cPRA is an indicator of how broadly any patient’s HLA antibody reacts to random donors. Elevated cPRAs may reflect a higher level of difficulty in finding an acceptable donor.
A positive flow cytometry crossmatch indicates the likely presence of donor specific antibodies.
Special Processing: Deceased donor crossmatch situations should be considered STAT and sample delivery should be handled accordingly.

SRA staff: when the blood arrives, please page the Transplant Laboratory Technologist or the Donor Coordinator/Donor Transplant Specialist according to current policies.
Comments: Stat T.A.T:
Prospective HLA Typing: 4 to 5 hours from when the technologist is notified and samples are available for testing.

Prospective crossmatching: 4 to 6 hours from when the technologist is notified. Crossmatching of imported donors for HSP recipients may take longer since the HLA typing will be confirmed at this time

A deceased donor situation must be coordinated by TGLN and/or the local Donor Coordinators/Donor Transplant Specialists.

TGLN: 1-877-363-8456
Local Donor Coordinators: contact LHSC switchboard @ 519-685-8500
Method of Analysis: HLA Class I and Class II typings are performed using molecular techniques (RSSO, SSP or RT-PCR).
Allogenic crossmatches are performed using flow cytometry.

cPRA determinations are based on specificities detected with solid phase bead technology using the Luminex® platform.
Critical Information Required:  
Storage & Shipment: Transport and store blood at room temperature.
Transport and store spleen refrigerated.
System Codes: 
Cerner
HLA Workup Deceased Donor
 
Referred To:  

Questions? Comments? Contact Laura Gopaul