Chapters authored
The Human Leukocyte Antigen System: Nomenclature and DNA-Based Typing for Transplantation
The major histocompatibility complex in humans, known as the human leukocyte antigen (HLA) and located on chromosome 6, is the most polymorphic genetic system in humans. The biological role of the HLA class I and class II molecules is to present processed peptides to CD8+ and CD4+ T lymphocytes, respectively. These cells can also respond to foreign (allogeneic) HLA molecules (direct allo-recognition) or to foreign HLA-derived peptides (indirect allo-recognition), respectively. Thus, the HLA system controls the acceptance or rejection of transplanted foreign tissues and organs (allografts). High-resolution HLA typing is routinely performed to provide HLA matching in hematopoietic stem cell transplantation to prevent allograft rejection and graft-versus-host disease. In contrast, low-resolution HLA typing is routinely performed in solid organ transplantation to provide HLA matching but, most importantly, to allow for the detection of donor-specific antibodies to prevent antibody-mediated allograft rejection. The capability to amplify DNA by polymerase chain reaction has facilitated the clinical application of molecular techniques and, currently, several molecular HLA typing methods are now available in the histocompatibility laboratory. Herein, we describe the different molecular HLA typing techniques and the different levels of HLA typing resolution used for clinical purposes.
Part of the book: Human Leukocyte Antigens