Histocompatibility testing; Lympho cytotoxicty test and cross matching MHC.

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 Histocompatibility testing is a crucial component of organ transplantation and bone marrow transplantation. It assesses the compatibility between the donor and recipient in terms of their major histocompatibility complex (MHC) antigens, also known as human leukocyte antigens (HLA) in humans. Two common histocompatibility tests are lymphocytotoxicity testing and cross-matching:

  1. Lymphocytotoxicity Test (also called the Microcytotoxicity Test or Tissue Typing):
    • Principle: This test assesses the compatibility of MHC Class I antigens (HLA-A, HLA-B, and HLA-C) between the potential donor and recipient. It is typically performed before transplantation to determine the degree of HLA matching between the two individuals.
    • Procedure:
      • Blood samples from the donor and recipient are collected.
      • Lymphocytes (white blood cells) are isolated from these samples.
      • The lymphocytes from the donor are mixed with antibodies specific to the recipient's HLA antigens. If there is a match, the antibodies will bind to the donor's lymphocytes, causing them to be destroyed (cytotoxicity).
      • The degree of cytotoxicity is assessed, and the results are used to determine the level of compatibility.
    • Applications: Lymphocytotoxicity testing helps identify potential organ or tissue donors who are a good match for the recipient in terms of MHC Class I antigens. A better HLA match typically results in a lower risk of transplant rejection.
  1. Cross-Matching:
    • Principle: Cross-matching is performed to assess compatibility at the MHC Class I and Class II levels between the donor and recipient. It is a more comprehensive test than lymphocytotoxicity testing.
    • Procedure:
      • Cross-matching involves mixing the recipient's serum with the donor's lymphocytes and vice versa.
      • The serum from the recipient may contain antibodies against the donor's MHC antigens. If these antibodies bind to the donor's lymphocytes, it indicates a potential risk of hyperacute rejection.
      • The cross-matching results are used to determine the suitability of the donor-recipient match and the risk of transplant rejection.
    • Applications: Cross-matching is critical in organ and bone marrow transplantation to ensure that the donor and recipient are compatible at multiple levels of the MHC. It helps prevent hyperacute rejection and improves the overall success of the transplantation.

Both lymphocytotoxicity testing and cross-matching are essential steps in the evaluation of donor-recipient compatibility before transplantation. They help transplant teams make informed decisions regarding donor selection, immunosuppressive therapy, and the overall management of the transplantation process to minimize the risk of graft rejection and improve patient outcomes.

 

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