TRANSPLANT BIOLOGY

We have finest molecular techniques like extraction, SSP, PCR and HLA-crossmatch , required to offer a successful organ transplant. Again, first of its kind in the region.

Human leukocyte antigens are glycoproteins that reside on the surface of almost every cell in the body. The primary function of these antigens is to serve the recognition ofmolecules in the initiation of an immune response. HLA antigens are located on the specialised immune cells present peptides from foreign substances (e.g. viruses and bacteria) to effector cells of the immune system. There are two major classes of HLA antigens; HLA class I (HLA-A, -B and -C) and HLA class II (HLA-DR, -DQ and -DP).They play an important role in the field of transplant immunology especially in renal, and bone marrow transplant. But recently its role has been established in all kinds of solid organ transplants

Human Leukocyte Antigen (HLA) Testing

Human Leukocyte Antigen (HLA) testing, also known as HLA typing or tissue typing, is used to identify antigens on blood cells to determine the compatibility between an organ recipient and a donor organ. If HLA antigens of the recipient are well matched with a donor organ, the possibility of organ rejection is minimised. However, HLA matching is more complex than blood group matching because there are six loci on chromosome 6 where the genes that code HLA antigens are inherited (HLA-A, HLA-B, HLA-C, HLA-DR, HLA-DQ, and HLA-DP). In classical serological HLA testing, antibodies are used to distinguish between different variants of HLA antigens. Each antibody is specific for a particular antigen, and by using different antibodies HLA serotyping is performed to determine if the donor serotype is a good match for the recipient. However, serological testing is limited by the number of antibodies available against specific HLA antigens. More recently, molecular techniques have been used for HLA DNA typing; these are superior to classical serological tests. The HLA Class I genes are by far the most polymorphic genes in the human genome. Current molecular techniques for HLA DNA typing include recombinant DNA technology, chain-termination Sanger sequencing, and polymerase chain reaction (PCR)-based amplification. These molecular tests can recognise more alleles than traditional serological testing .

HLA typing along with ABO (blood type) grouping is used to evaluate tissue compatibility between a donor and a potential transplant recipient. HLA typing is performed before various transplant procedures, including those for kidneys, liver, heart, pancreas, and bone marrow. The success of a transplant increases with the number of identical HLA antigens between a recipient and a potential donor. Major types of HLA testing include:

• HLA antigen typing between donor and recipient: Classically this type of testing is done using serological markers, but more recently molecular (DNA) typing (which provides more information) is replacing classical serological testing.
• HLA antibody screening: Performed on the recipient in order to determine if there is any antibody present that might target donor organs, which would trigger organ rejection. HLA antibody is not always present in an individual unless the person has received a blood transfusion or is a woman post-pregnancy.
• Lymphocyte cross-matching: This step takes place when a donor is identified; the objective is to identify any antibody that, if present in the recipient, might be directed against antigens present on the donor’s lymphocyte. In this test, serum from the intended recipient is mixed with T and B lymphocytes (white blood cells) from the donor to investigate potential reactions (a positive test result) that might destroy white blood cells of the recipient.

Both cross matching and typing techniques are developing very fast. All advances are adding disadvantages in this field. It is a very complex field needs special expertise therefore with this service, not only Jalandhar but entire Punjab and referring states can be benefitted.

Along with HLA and cross match the hospital can provide single antigen testing required for rheumatoid arthritis, ankolysing spondylitis, coeliac disease, Abacavir sensitivity and Narcolepsy. All these tests provide accuracy up to 90 95% while other tests for RSA having a success rate of 77%.

TRANSPLANT BIOLOGY

We have in-house testing of HLA typing cross match established by pioneer in the field of transplant biology, Dr. Suraksha Agrwal, EX HOD Genetics, S.G.P.G.I. Lucknow.

TRANSPLANT PATHOLOGY

We have in-house complete facilities of Histopathology for Kidney disease and transplant established by Prof. Kusum Joshi Ex HOD, P.G.I.M.E.R. CHANDIGARH.

TRANSPLANT NEPHROLOGY

Dr. Rajeev Bhatia and Dr. Ajay Marwaha have a 20-year experience in transplant nephrology.

TRANSPLANT SURGERY

Since 1995 we are actively involved in Renal Transplant. We have done more than 300 Renal Transplants so far.