HLA Testing & Cell Transplantation
Human leukocyte antigen (HLA typing)
The human leukocyte antigen (HLA) system is a group of cell-surface proteins on chromosome 6 that are involved in the immune system’s response to bacterial or viral antigens and for differentiating self from non-self. HLA has become an important marker in the support of clinical trials and the emerging field of cell therapy and regenerative medicine.
HLA Typing Applications
- Selection of the correct HLA alleles to display different peptide repertoires for use in vaccines or other therapies
- Monitoring of adverse drug effects, such as drug-induced antibody formation or drug hypersensitivity
- Intentional mismatching of HLA to elicit a cellular response
- Engineering cells to target a specific HLA type to control non-target (off-target) reactivity
- Better matching of cellular products to prevent allosensitization
Versiti is a leader in HLA typing and our state-of-the-art histocompatibility lab has been at the forefront of HLA testing for more than 30 years. Versiti offers several resolutions of HLA typing for both Class I and Class II loci to fit a variety of clinical and research scenarios.
Loci available: HLA-A, B, C, DRB1, DRB3,4,5, DQA1, DQB1, DPA1, DPB1
HLA High-Resolution Typing
High-resolution typing by next-generation sequencing (NGS) provides greater sensitivity and is required when allele-level information is critical. High-resolution testing can provide information for 3+ fields with minimal ambiguity, e.g. HLA-A*02:01:01 or HLA-DR*04:01:02.
HLA Intermediate & Low-Resolution Typing
HLA low to intermediate typing provides lesser sensitivity than high-resolution testing. Low-resolution typing is most often used where donor/recipient matching is not stringent and provides information limited to the first field, e.g., HLA-A*02. Intermediate resolution typing is required where a higher level of matching is needed or where the probability of incurring an antibody response is heightened. Information is often provided for two fields, e.g. HLA-A*02:0.
HLA proteins are of a highly polymorphic nature; they are immunogenic and can stimulate antibody production when cells or tissue containing non-self HLA is introduced into the body. Versiti offers two types of HLA antibody testing and virtual crossmatching.
- HLA antibody detection: broadly detects presence of Class I and Class II directed HLA antibodies with reporting as percent panel reactive antibody (PRA)
- HLA antibody identification: separate assays detect the presence and specificity of Class I or Class II HLA antibodies with a panel of specific recombinant HLA antigens
- Virtual crossmatch: provides an assessment of patient’s antibody strength against a donor or a product. The antibody specificities are assessed for the presence of donor-specific antibodies (DSA)
HLA typing for single-allele detection is available for disease associations and drug hypersensitivity testing. Versiti offers the following single-allele detection testing:
- HLA-A*02:01 associated with drug sensitivity and immunotherapy development
- HLA-A*29 birdshot uveitis
- HLA-B*15:02 carbamazepine hypersensitivity
- HLA-B57:01 abacavir hypersensitivity
- HLA-B27 ankylosing spondylitis and other spondyloarthropathies
- HLA-B51 associated with several diseases, including Behçet’s disease
- HLA-DQ6 and/or DR15 for narcolepsy
- HLA-DQA1 and DQB1 for celiac disease
Chimerism Testing
Chimerism testing can be used to distinguish cells of different origins through amplifying highly polymorphic short tandem repeats (STRs) and variable number tandem repeats (VNTRs). Testing should be performed pre-infusion to determine which loci to use to uniquely identify recipient and donor alleles and post-infusion to establish relative amounts of recipient and donor DNA.
KIR Genotyping
Killer cell immunoglobulin-like receptors (KIR) contribute to the ability of natural killer (NK) cells to recognize and kill malignant cells. KIR genotyping identifies the KIR genes present and may impact the selection of donor cells.
Jennifer J. Schiller, PhD, F(ACHI)
Dr. Schiller is the senior director of histocompatibility and immunogenetics at Versiti Diagnostic Laboratories.
Matthew Anderson, MD, PhD
Dr. Anderson leads Versiti's Medical Sciences Institute (MSI), providing strategic leadership and guiding innovative research and clinical programs.