HUMAN LEUKOCYTE ANTIGENS

A. Testing Applications in the Clinical Laboratory

 HLA antigens and antibodies are involved in transfusion and transplantation medicine
 These antibodies can cause poor platelet response, or refractoriness, in patients
requiring platelet transfusion
 Transplants rely on HLA matching for the best outcome
B. Inheritance and Nomenclature of HLA
 Part of the MHC gene system located on chromosome 6
 MHC is essential in
o Recognition of self and non-self
o Coordination of cellular and humoral immunity
o Immune response
 Divided into 3 regions: class I, class II, and class III
 MHC is the most polymorphic system of genes in humans

*insert HLA Nomenclature table 7.19 here*

C. HLA Testing Applications

 Organ and cell transplantation
 Platelet selection
 Disease association
o Ankylosing spondylitis – B27
o Celiac disease – DQ2
 Drug therapy regimens
D. Testing to Identify HLA
 Requires the lymphocytotoxicity method
 Class I antigens: surface of platelets, leukocytes, most nucleated cells of the body
 Class II antigens: APCs
E. Antibody Detection and Identification
 Patients can become sensitized to HLA antigens by:
o Pregnancy
o Blood transfusions
o Previous transplant
 Calculated panel-reactive antibody: *copy the definition sa right side ng page 175*
 Crossmatching is another important procedure in identifying antibodies in order to
avoid rejection
o Mixed lymphocyte culture was used for crossmatching but is now replaced by
immunofluorescent flow cytometric techniques