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New! Directors' and Technologists' Online Forums!


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Current Forum topics being discussed include:

Directors Forum
P. Lalli: DP Antibody in Heart, TX
I have a patient on our heart waiting list that was on ECMO and has an RVAD and LAVD implanted. He is very highly sensitized with a Bw4 antibody, additional B unacceptables, DR, DQ and DP antibodies. Our big concern is with his DP antibodies. He is DPB1*04:01 homozygous with antibodies >10,000 to almost all other DP antigens. We have done several surrogate crossmatches and they have all been B cell positivewith anyone that is not 04:01 homozygous.

Does anyone have experience performing heart transplants across DP positive crossmatches? Did the patients have any issues post transplant? I know some have done kidney transplants with some success, but I have not seen any data about hearts.


J. Schmitz: SAB Testing
I am interested in polling forum members to see how many labs use either EDTA treatment of serum or use a dilution (not endpoint titer) to address interferences such as prozoning for SAB testing. Please respond with any of the following:

No pretreatment
EDTA
Dilution
Other
I will share my findings when complete
.

E. Cooper: Contacting patients for serum specimens

Our lab is getting pressure (led by the renal transplant coordinators) to be responsible for contacting patients who have not had their samples submitted for monthly antibody testing. I am curious whether some labs do this, rather than insisting that the coordinators, who already know the patients, be the contact persons. I feel that it is not the lab's responsibility.

Technologist Forum
What current challenges are you facing as a technologist?
S. Frick: The challenge I am currently facing is trying to figure out why one of our patients comes up positive with EVERY DR bead on the Luminex SA assay. Has anyone ever seen this before or have any recommendations? Would be much appreciated!

P. Kuchipudi: We did see in our lab on a recipient who is male and had no sensitizing events. This is PAN-DR antibodies. PRA was negative and Class SAB was negative. Something in the patient's serum is reactive to the epitope. Antibodies detected in these patients were possibly against denatured HLA antigens, more likely to a shared epitope uncovered on denatured DR antigens. Antibodies to denatured antigens would not result in crossmatch reactivity.
For more reference: google for '180-P Characterization of PAN-DR antibodies.'


Member Forum
How did you get started in HLA?
D. Hartzell: I spent my 4th year of college attaining a certification as a Medical Technologist. My first job out of school was as a generalist in a hospital laboratory on swinging shifts and performing phlebotomy. Just before I was to start on night shift I applied and was hired for a DAYSHIFT position in Hematology. My favorite part of that job was the "special stains" we did for leukemia. After 2 ½ years I transferred to Blood Bank as I liked the more "hands on" nature that the job offered. Another 2 ½ years passed and a new position was created for a part-time evening shift technologist in our fairly new HLA lab. I was the third technologist on the staff! I love the more


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