- Specialised Laboratory Services Department
- Paternity Testing
- Cyropreservation Facility
- Other SANBS Service Information
Specialised Laboratory Services Department
(i) HLA Serology typing
The Tissue Immunology and Paternity Laboratory have a close partnership with the Sunflower Fund, and the South African Bone Marrow Registry (SABMR).
The Sunflower Fund is responsible for creating awareness and education in the community. Funds raised assist with the cost incurred for laboratory testing. Blood samples are collected from donors and subjected to HLA Class I typing (Locus A + B). The test results are then released to the SABMR who capture and include the typings on the register.
Should you require further information on how to become a bone marrow donor, please contact the SUNFLOWER FUND
A link between some HLA types and certain disease has been researched and documented e.g. locus B27 is associated with Ankylosing Spondylitis. Class I typing by serology can then be performed to determine whether the patient posesses this antigen and therefore is at risk for the disease.
(ii) HLA Molecular Class I and II Typing
Molecular typing is used as a powerful tool to further tissue type patients requiring solid organ and bone marrow transplantation.
Potential donors who have HLA matched a patient at a serological level, are then further typed to confirm HLA compatibility.
Requests are received from the SABMR to contact bone marrow donors who have potentially matched a patient at a serological level. The laboratory then performs molecular typing to ascertain the HLA Class II type i.e. Locus DRB.
(iii) HLA antibody screening and identification
Renal patients are tested on a regular basis for the presence of HLA antibodies. These antibodies are produced as a result of sensitizing factors, such as transfusions and pregnancies. The antibodies are detected by an ELISA-based method and identified by a lymphocytotoxicity method.
There are two types of donors for these patients; the first is the related living donor (RLD). The second type of donor is the cadaver donor, who is a person who has been declared brain-dead and permission has been obtained from family for the use of his/her organs.
A crossmatch between the patient’s serum and donor’s T and B lymphocytes is performed by a complement-dependant cytotoxicity method. A positive T cell x-match is a contraindication for transplantation with the donor. A positive B cell x-match, when the patient has antibodies, also carries a high risk of antibody-mediated damage and possible organ rejection.
Patients awaiting solid organ transplantation regularly submit samples to the laboratory to monitor their antibody status and for inclusion onto the transplant list. All patients awaiting transplantation are crossmatched against cadaver lymphocytes, and those patients who are negative for T and B cell crossmatches and are then considered for transplantation. The decision on whom to transplant rests with the nephrologist and surgeon.