Basic Histocompatibility Testing Methods

Predicting humoral alloimmune potential in transplant recipients is the objective of histocompatibility testing and depends upon accurate donor typing and sensitive and specific testing for antibodies to human leukocyte antigen. This review for the transplant clinician will describe the evolution and current widespread practices of histocompatibility testing methods for typing, crossmatching, and antibody screening. Newer methods such as measuring T cell alloimmune potential will not be discussed as they are beyond the scope of this basic overview and are not routinely practiced in all histocompatibility laboratories at this time. Emphasis is given to the clinical applicability and limitations of each test, and the collective consideration of all tests in concert, as part of the immunologic risk assessment of the solid organ transplant recipient.

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