3 years ago

Assessing the utilization of high‐resolution two‐field HLA typing in solid organ transplantation

Yanping Huang, Anh Dinh, Steven Heron, Allison Gasiewski, Carolina Kneib, Hilary Mehler, Michael T. Mignogno, Ryan Morlen, Larissa Slavich, Ethan Kentzel, Edward C. Frackelton, Jamie L. Duke, Deborah Ferriola, Timothy Mosbruger, Olga A. Timofeeva, Steven S. Geier, Dimitri Monos

Abstract

HLA typing in solid organ transplantation (SOT) is necessary for determining HLA matching status between donor‐recipient pairs and assessing patients’ anti‐HLA antibody profiles. Histocompatibility has traditionally been evaluated based on serologically‐defined HLA antigens. The evolution of HLA typing and antibody identification technologies, however, has revealed many limitations with using serological equivalents for assessing compatibility in SOT. The significant improvements to HLA typing introduced by next‐generation sequencing (NGS) require an assessment of the impact of this technology on SOT. We have assessed the role of high‐resolution two‐field HLA typing (HR‐2F) in SOT by retrospectively evaluating NGS‐typed pre‐ and post‐ SOT cases. HR‐2F typing was highly instructive or necessary in 41% (156/385) of cases. Several pre‐ and post‐transplant scenarios were identified as being better served by HR‐2F typing. Five different categories are presented with specific case examples. The experience of another center (Temple University Hospital) is also included, whereby 21% of cases required HR‐2F typing by Sanger sequencing, as supported by other legacy methods, to properly address post‐transplant anti‐HLA antibody issues.

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