Tissue Typing
-
Upload
petra-sutton -
Category
Documents
-
view
49 -
download
2
description
Transcript of Tissue Typing
![Page 1: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/1.jpg)
Tissue Typing
![Page 2: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/2.jpg)
Everyone has several antigens located on the surface of his/her
leukocytes:
• One particular group of these antigens is called the HLA (Human Leukocyte Antigens).
![Page 3: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/3.jpg)
The HLA
• Is responsible for stimulating the immune response to recognize tissue as self versus non-self.
• Is controlled by a set of genes located next to each other on chromosome 6 called the Major Histocompatibility Complex (MHC).
![Page 4: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/4.jpg)
![Page 5: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/5.jpg)
• The test that determines which HLA antigens are present is called tissue typing or HLA typing.
–Tissue typing identifies the similarity of the antigens present in both the donor and the recipient.
![Page 6: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/6.jpg)
• The closer the HLA antigens on the transplanted organ match the recipient, the more likely that the recipient’s body will not reject the transplant.
• For this reason, tissue typing of the kidney donor and recipient is necessary before a kidney transplantation.
![Page 7: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/7.jpg)
There are two main classes of HLA antigens:
• Class I (HLA-A, HLA-B, and HLA-Cw)
• Class II (HLA-DR, HLA-DQ, and HLA-DP)
![Page 8: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/8.jpg)
• Every person inherits each of the following antigens from each parent:– HLA-A antigen– HLA-B antigen– HLA-Cw antigen– HLA-DR antigen– HLA-DQ antigen and– HLA-DP antigen
![Page 9: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/9.jpg)
![Page 10: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/10.jpg)
• The set of HLA antigens received from a parent is called a haplotype.–There are a variety of alleles for
each of these HLA antigens.
![Page 11: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/11.jpg)
–The large number of possible variations and combinations of HLA antigens make finding a match in a family more likely than finding a match in the general public.
![Page 12: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/12.jpg)
• When performing an HLA typing test for a kidney transplant, the following HLA antigens are looked at:– HLA-A – HLA-B– HLA-DR
![Page 13: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/13.jpg)
• The MHC genes are the most polymorphic known.– There are hundreds of known alleles for each
HLA Antigen.• Each allele is identified by a number (i.e. HLA-A1
or HLA-A2).
![Page 14: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/14.jpg)
• Six HLA antigens are looked at for each person.– Remember each person has two of each of
the antigens (one inherited from the mother and one inherited from the father).
![Page 15: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/15.jpg)
• By analyzing which six of these HLA-antigens both the donor and recipient have, scientists are able to determine the closeness of tissue matching.– A six-antigen match is the best compatibility
between a donor and recipient.• This match occurs 25% of the time between
siblings who have the same mother and father.
![Page 16: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/16.jpg)
HLA Typing Techniques
• Traditionally, HLA typing was done using serological techniques:– Blood from the patient was mixed with serum
containing known antibodies to determine which antigens were present.
• HLA typing now is predominantly done using molecular techniques:– Patient’s DNA is isolated.– PCR is used to amplify specific HLA genes.– Genes are sequenced to determine which alleles are
present.
![Page 17: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/17.jpg)
• Once the donor and recipient have been tested for tissue compatibility, the next step is an Antibody Screening (also called a Panel Reactive Antibody or PRA).– A small amount of the organ recipient’s serum
is mixed with cells from 60 different individuals (each test is done separately).
![Page 18: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/18.jpg)
Purpose of Antibody Screening
• Scientists can determine how many different HLA antibodies a patient has in his/her blood.– If a patient reacts with 30/60 cells, he/she is
said to have 50 Percent Reactive Antibody (also known as PRA).
– The lower a person’s PRA, the less likely he/she is to reject a transplant.
![Page 19: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/19.jpg)
Crossmatch Test
• After tissue typing and antibody screening are complete and a potential donor has been identified, the final test is called a crossmatch test. – Crossmatch Test: A small amount of the
potential donor’s white cells is mixed with a small amount of the recipient’s serum.
• By exposing the donor’s HLA to the recipient’s serum, scientists can determine if the recipient has antibodies to any of the donor’s HLA.
![Page 20: Tissue Typing](https://reader035.fdocuments.in/reader035/viewer/2022062407/56812ea9550346895d9448ce/html5/thumbnails/20.jpg)
• Positive Crossmatch: A reaction between the donor’s and recipient’s samples occurs.– Indicates that the recipient’s body will likely reject the
implanted kidney.– Indicates the transplant cannot be performed.
• Negative Crossmatch: No reaction between the donor’s and recipient’s samples occurs.– Indicates that the recipient’s body will most likely not
reject the implanted kidney.– Indicates the transplant can be performed.