Tissue typing

Alternative names
HLA typing; Histocompatibility antigens

Definition
This is a blood test that determines a person’s major histocompatibility antigens.

How the test is performed

Blood is drawn from a vein, usually on the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic, and an elastic band is placed around the upper arm to apply pressure and restrict blood flow through the vein. This causes veins below the band to fill with blood.

A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the tourniquet is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

For an infant or young child:
The area is cleansed with antiseptic and punctured with a sharp needle or a lancet. The blood may be collected in a pipette (small glass tube), on a slide, onto a test strip, or into a small container. Cotton or a bandage may be applied to the puncture site if there is any continued bleeding.

How to prepare for the test
No preparation is necessary.

For infants and children:
The preparation you can provide for this test depends on your child’s age and previous experiences. For specific information regarding how you can prepare your child, see the following topics:

     
  • infant test or procedure preparation (birth to 1 year)  
  • toddler test or procedure preparation (1 to 3 years)  
  • preschooler test or procedure preparation (3 to 6 years)  
  • schoolage test or procedure preparation (6 to 12 years)  
  • adolescent test or procedure preparation (12 to 18 years)

How the test will feel
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the test is performed

HLA (human leukocyte antigens) are proteins found in the membranes (outer coating) of nearly every cell in the body (all cells that have a nucleus). These antigens are in especially high concentrations on the surface of white blood cells (leukocytes).

HLA antigens are the major determinants used by the body’s immune system for recognition and differentiation of self from non-self (foreign substances). There are many different major histocompatibility (HLA) proteins and individuals possess only a small, relatively unique set that is inherited from their parents. It is unlikely that 2 unrelated people will have the same HLA make-up.

Children, on average, will have one-half of their HLA antigens that match one-half of their mothers antigens; the other one-half of the child’s antigens will match one-half of their father’s antigens. This is particularly important in identifying good “matches” for tissue grafts and organ transplants, such as a kidney transplant or bone marrow transplant.

Many HLA molecules exist, but some are of special interest because they are more common in certain autoimmune diseases. For example, HLA-B27 antigen is found in 80-90% of people with ankylosing spondylitis and Reiter’s syndrome, and can aid in the diagnosis of these diseases. HLA-B27 is also present in 5-7% of people without autoimmune disease. Thus, the mere presence of this HLA molecule is not indicative of disease.

HLA types can also used to determine relationships between children and parents when such relationships are in question. However, newer, more specific genetic testing is now available for this purpose.

Normal Values
Each person has unique HLA antigens (although identical twins may match each other).

What abnormal results mean
Each person has unique HLA patterns. However, some HLA types are associated with certain conditions. (See “Why is the test performed”.)

What the risks are

     
  • excessive bleeding  
  • fainting or feeling light-headed  
  • hematoma (blood accumulating under the skin)  
  • infection (a slight risk any time the skin is broken)  
  • multiple punctures to locate veins

Special considerations
Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.