1. HLA - Tissue Typing Laboratory HLA - Tissue Typing Laboratory Department of Pathology & Laboratory Medicine Human Leukocyte Antigen (HLA) complex allows the body to distinguish between its own proteins and the proteins of foreign invaders. Located on chromosome 6 in humans, the study of HLA is essential in organ transplantation. The HLA lab at UR Medicine is made up of one Faculty Director, one Supervisor, six Medical Technologist Specialists and one Support Tech. The staff works closely with the Renal, Heart and Bone Marrow transplant teams, as well as with the Organ Procurement team with Finger Lakes Donor Recovery Network. The Technologists are on-call to facilitate deceased donor organ transplant24 hours a day, 365 days a year. The workup for an average deceased donor takes 8 hours to complete and technologists must report immediately when paged. Angela Busacco: Supervisor Dr. Myra Coppage: Lab Director Top row: Jonathan Hoffmann, Karen Kryder, Li Zhang Bottom row: Tia LaBarge, Ricardo Rivera, Will Femec Not Pictured: Nancy Mistretta Acceptable Samples: Red top tubes and Serum Separator Tubes (SST)- Used to screen transplant recipients for antibody before and after transplant. Lavender and Yellow (ACD) top tubes - Used for genetic typing of Donors and Recipients, in addition, to screening for disease. Green top (Sodium Heparin tubes)- Used for screening of potential Bone Marrow Sibling donors and cross matching for living related donors in renal transplant. Total by Quarter RenalHeartLiver and Kidney HLA work up, DNU * Quarter 14307 Quarter 27307 Quarter 3145210 Quarter 411409 NYFL Deceased Donor Solid Organ Transplants 2015 *DNU-Donor not used Active Listed Renal patients in NYFL: 247 Active Listed Heart patients in NYFL: 18 OrganNumber of Patients Kidney349 Heart24 Liver48 Pancreas4 Kidney/Pancreas11 Liver/Kidney2 Current UNOS Waitlist: Solid Organ Transplant at UR Medicine ~300-400 active donors Donors are screened using a virtual crossmatch to find suitable recipients Crossmatching can be performed using frozen lymphocytes when necessary Longest Transplant Chain was 34 Donor/Recipients over a 3 month period. UR Medicine has facilitated 10 transplants through the NKR. Most NKR transplants are due to ABO incompatibility between donor and recipients, but 4 were performed due to high reactive antibody. National Kidney Registry Located 2-3670 Hours of Operation: 7am-5pm HLA tech on-call 24 hours /day In 2015, the HLA lab matched 70 patients from both related and unrelated donors. (35 related/35 unrelated) Average age of patient at time of transplant is 45.2 years old. At 40%, Acute Myeloid Leukemia was the most common diagnosis in patients receiving a transplant in 2015. The HLA lab tests siblings and parents to find acceptable matches. They also test donors from the National Marrow Donor Program (NMDP) and donors from all over the world. Typing a matching donor costs at least $10,000. Bone Marrow Transplant Accessioned samples 2015 = 5936 Tests performed 2015= 15,495 The HLA lab does more than type and match transplant Recipients and Donors. We also test for diseases associations… Reactive ArthritisJuvenile Rheumatoid Arthritis Bechet's DiseaseCeliac Disease Ankylosing SpondylitisBirdshot Chorioretinopathy LupusDrug Sensitivity in HIV Patients NarcolepsySjogren’s Syndrome