Solid organ transplantation, i.e. kidney
- The patient is HLA typed using PCR SSO (Sequence Specific Oligonucleotides) Luminex typing (DNA is isolated from blood in EDTA tube).
- Once in three months, the serum of the patient is screened using Complement Dependent Cytotoxicity (serum of the donor against the panel of cells) or Luminex screening (serum of the patients on beads). There is also more specific Luminex exist (more expensive), using Luminex Specific Antigen.
- When there is donor available, immediately, the HLA PCR SSP typing will be performed (Sequence Specific Primer, this is shorter than SSO, because it uses the DNA product directly, without denaturization and anealing).
- The results of the typing is sent immediately to Eurotransplant. The candidates are selected with based on HLA typing.
- Candidates with negative serum anti HLA is prefered, if this is the case, at least 2 DRs or 1 DR and 1 B should be compatible.
- The serum of the potential candidate is screened in the hospital of the donor. (This serum and other serum of candidates in the list are sent every three months to all participating center).
- When the serum is also compatible, Eurotranpslant contact the team of potential acceptor. Also to bee screened several items, for example age, number of particiapnts of the center, etc. first candidate will be the candidate with negative antibody.
Stem cell transplantation
- The patient is HLA typed (A, B, C, DR, DQ) using gene sequencing (with 4 digits, high resolution (using forward and backward primer vs. PCR SSO with 2 digits).
- The first candidates for donor are the brothers or sisters. 25% chance to have the same haplotype (inheritance of multiple loci).
- If the sibling does not share the same haplotype, match unrelated donor can be search, first using the database within the country than abroad. The typing should be at least 9/10.
- If the donor is found, the donor is prepared to receive colony stimulating factor (side effect: bone pain).
- The patient is HLA typed using PCR SSO (Sequence Specific Oligonucleotides) Luminex typing (DNA is isolated from blood in EDTA tube).
- Once in three months, the serum of the patient is screened using Complement Dependent Cytotoxicity (serum of the donor against the panel of cells) or Luminex screening (serum of the patients on beads). There is also more specific Luminex exist (more expensive), using Luminex Specific Antigen.
- When there is donor available, immediately, the HLA PCR SSP typing will be performed (Sequence Specific Primer, this is shorter than SSO, because it uses the DNA product directly, without denaturization and anealing).
- The results of the typing is sent immediately to Eurotransplant. The candidates are selected with based on HLA typing.
- Candidates with negative serum anti HLA is prefered, if this is the case, at least 2 DRs or 1 DR and 1 B should be compatible.
- The serum of the potential candidate is screened in the hospital of the donor. (This serum and other serum of candidates in the list are sent every three months to all participating center).
- When the serum is also compatible, Eurotranpslant contact the team of potential acceptor. Also to bee screened several items, for example age, number of particiapnts of the center, etc. first candidate will be the candidate with negative antibody.
Stem cell transplantation
- The patient is HLA typed (A, B, C, DR, DQ) using gene sequencing (with 4 digits, high resolution (using forward and backward primer vs. PCR SSO with 2 digits).
- The first candidates for donor are the brothers or sisters. 25% chance to have the same haplotype (inheritance of multiple loci).
- If the sibling does not share the same haplotype, match unrelated donor can be search, first using the database within the country than abroad. The typing should be at least 9/10.
- If the donor is found, the donor is prepared to receive colony stimulating factor (side effect: bone pain).
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