Pitfalls and troubleshooting in histocompatibility tests

Abstract

Histocompatibility testing requires not only specialized knowledge of human leukocyte antigen (HLA) systems but also consistent technical proficiency and the ability to accurately interpret test results. In transplantation medicine, histocompatibility testing plays a critical role in donor selection and transplant outcomes. However, because many of these assays are performed manually, they are susceptible to inter-operator variability and day-to-day fluctuations. Furthermore, although appropriate training is essential for acquiring the necessary technical skills, many laboratories have a limited number of personnel dedicated to histocompatibility testing, and staff are often required to perform multiple duties. Consequently, opportunities for comprehensive hands-on training, including troubleshooting experience, are frequently insufficient. In this workshop, we will present practical information for such laboratory professionals by focusing on HLA DNA typing using the PCR-reverse sequence-specific oligonucleotide (PCR-rSSO) method and anti-HLA antibody testing using the indirect immunofluorescence assay. Common pitfalls encountered during testing and approaches to troubleshooting will be reviewed.