HLA Functionality and ABO/Rh in Transplantation

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The page below is a sample from the LabCE course The Human Leukocyte Antigen (HLA) System. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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HLA Functionality and ABO/Rh in Transplantation

The transplantation risks can for patients with various types of organ failure, dysplastic syndromes, aplastic anemias, and cancers, can be assessed using HLA typing. Bone marrow transplants can be useful for ALL, AML, CLL, CML, and sickle cell disease.
When a patient needs a tissue transplant, recipients are tested to obtain baseline levels of (any) preformed antibodies by HLA antibody screening, ABO/Rh testing, and recipient HLA typing. These data points are submitted to the United Network for Organ Sharing (UNOS). The patient's information is listed and put on a waiting list based on various criteria to determine this particular patient's need of an organ compared to other patients. If matches are found, further testing is performed between the two individuals.
HLA A, B, C, DR, DP, and DQ are the classic HLA antigens used to determine optimal transplants of organs. In the perfect scenario, a patient will be a 12/12 match for all donor HLA alleles.
ABO/Rh compatibility is also very important for solid organ transplantations. Kidneys for example should be ABO matched as ABO can be expressed on those tissues.
17. InvictaHOG. "Diagram of ABO blood groups and the IgM antibodies present in each." Wikimedia Commons, 3 Mar 2020, https://commons.wikimedia.org/wiki/File:ABO_blood_type.svg

ABO Blood Types with associated antigens and antibodies (17).