Tissue Typing: Crossmatch, Antibodies, and Risk Analyses of Transplant Rejection

The rapid and ever-expanding development of methods to genetically type human leukocyte antigens (HLA), as well as to detect and define antibodies to HLA, has greatly aided the specialist tissue-typing or Histocompatibility and Immunogenetics (H&I) laboratories that facilitate renal transplant programs. All H&I laboratories work within the needs and specificities of their respective national organ sharing schemes, by performing a crucial role in the characterization of suitable organ donors and their immunological matching to patients requiring organ replacement therapy, as well as assessing and monitoring potential antibody-mediated rejection episodes in transplant recipients. H&I laboratories must be able to accurately identify HLA antibodies and many are also investigating non-HLA antibodies in relation to transplant rejection. Close collaboration with H&I laboratories is an integral part of any proactive transplant program with the capacity to expand and introduce new creative schemes to increase the availability of clinically viable resources to successfully treat end-stage renal failure.