tissue typing


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Tissue Typing

 

Definition

Tissue typing is a group of procedures that determines the type of histocompatibility antigens on a person's cells or tissues. This procedure is typically used prior to transplantation of tissues or organs.

Purpose

Tissue typing is done prior to transplantation to ensure as close a match as possible between the donor and the recipient. If the histocompatibility antigens do not match well, there is a much greater chance that the recipient will reject the donated tissue.
Histocompatibility antigens are molecules on the surface of all cells in the body. The specific types of histocompatibility antigens present on a person's cells determine their identity and distinguish each person. They are a "fingerprint."
Each person has a unique set of histocompatibility antigens. If the antigens on tissue or organs from a donor do not match that of the recipient, a rejection response can occur. The recipient's immune system will detect the difference between the two sets of antigen and start a rejection response to kill the donated tissue. Except in the case of identical twins, no two people are identical in terms of their histocompatibility antigen types. However, the closer two tissues come to matching, the more likely the recipient will accept the donated tissue or organ.
Human Lymphocyte Antigens (HLA) is the name given to the most commonly used histocompatibility antigens. The antigens can be grouped into two classes: class I antigens are found on almost all cells, and class II antigens are normally found only on B lymphocytes, macrophages, monocytes, dendritic cells, and endothelial cells.

Description

Generally, typing is performed on blood cells because they are an easy sample to obtain. Blood is withdrawn from a vein in the forearm, and the cells are separated. There are a number of different techniques used to identify the antigens on the cells. Typically, specific antibodies react with the cells. Each antibody preparation is specific for one histocompatibility antigen. If the antigen is present, the antibody will bind to it. Laboratory instruments are used to detect antibody binding to the cells. Class II antigens are determined by the mixed lymphocyte reaction (MLR) or by a polymerase chain reaction (PCR). In the mixed lymphocyte reaction, lymphocyte replication occurs if there is a mismatch, and is detected by a specific assay. The PCR test is a new DNA-based test that can detect the presence or absence of antigens by determining whether cells have the genes for the antigens.
One type of transplant does not require tissue typing. In the case of corneal transplants, tissue typing is not needed because cornea do not have their own blood supply. This greatly reduces the chance that immune cells will come in contact with the cornea and recognize it as foreign. For this reason, corneas can be transplant from any person, and there is little chance of rejection.

Normal results

Because each person has their own histocompatibility antigen "fingerprint," there is no true normal result. Each fingerprint is unique.

Resources

Books

Berkow, Robert, editor. Merck Manual of Medical Information. Whitehouse Station, NJ: Merck Research Laboratories, 1997.

Key terms

Antibody — A molecule produced by the body that is part of the immune response to attack antigens.
Antigen — A molecule that causes the body to produce an immunological response to attack the antigen.
Cornea — The transparent outer layer of the eye. It covers the iris and lens.
Lymphocyte — A class of white blood cells that are responsible for creating the immune response to antigens.

tissue

 [tish´u]
a group or layer of similarly specialized cells that together perform certain special functions.
adenoid tissue lymphoid tissue.
adipose tissue connective tissue made of fat cells in a meshwork of areolar tissue.
areolar tissue connective tissue made up largely of interlacing fibers.
bony tissue osseous tissue.
brown adipose tissue (brown fat tissue) brown fat.
bursa-equivalent tissue (bursal equivalent tissue) a hypothesized lymphoid tissue in nonavian vertebrates including human beings, equivalent to the bursa of Fabricius in birds: the site of B lymphocyte maturation. It now appears that B lymphocyte maturation occurs primarily in the bone marrow.
cancellous tissue the spongy tissue of bone.
cartilaginous tissue the substance of cartilage.
chordal tissue the tissue of the notochord.
chromaffin tissue a tissue composed largely of chromaffin cells, well supplied with nerves and vessels; it occurs in the adrenal medulla and also forms the paraganglia of the body.
cicatricial tissue the dense fibrous tissue forming a cicatrix, derived directly from granulation tissue; called also scar tissue.
connective tissue the tissue that binds together and is the support of the various structures of the body; see also connective tissue.
elastic tissue connective tissue made up of yellow elastic fibers, frequently massed into sheets.
endothelial tissue peculiar connective tissue lining serous and lymph spaces.
epithelial tissue a general name for tissues not derived from the mesoderm.
erectile tissue spongy tissue that expands and becomes hard when filled with blood.
fatty tissue connective tissue made of fat cells in a meshwork of areolar tissue.
fibrous tissue the common connective tissue of the body, composed of yellow or white parallel elastic and collagen fibers.
gelatinous tissue mucous tissue.
granulation tissue material formed in repair of wounds of soft tissue, consisting of connective tissue cells and ingrowing young vessels; it ultimately forms cicatrix.
gut-associated lymphoid tissue (GALT) lymphoid tissue associated with the gut, including the tonsils, Peyer's patches, lamina propria of the gastrointestinal tract, and appendix.
indifferent tissue undifferentiated embryonic tissue.
interstitial tissue connective tissue between the cellular elements of a structure.
lymphadenoid tissue tissue resembling that of lymph nodes, spleen, bone marrow, tonsils, and lymph vessels.
lymphoid tissue a latticework of reticular tissue whose interspaces contain lymphocytes.
mesenchymal tissue embryonic connective tissue composed of stellate cells and a ground substance of coagulable fluid.
mucous tissue a jellylike connective tissue, such as occurs in the umbilical cord. Called also gelatinous tissue.
muscular tissue the substance of muscle.
myeloid tissue red bone marrow.
nerve tissue (nervous tissue) the specialized tissue forming the elements of the nervous system.
osseous tissue the specialized tissue forming the bones.
reticular tissue (reticulated tissue) connective tissue composed predominantly of reticulum cells and reticular fibers.
scar tissue cicatricial tissue.
sclerous t's the cartilaginous, fibrous, and osseous tissues.
skeletal tissue the bony, ligamentous, fibrous, and cartilaginous tissue forming the skeleton and its attachments.
splenic tissue red pulp.
subcutaneous tissue the layer of loose connective tissue directly under the skin.
tissue typing identification of tissue types for purposes of predicting acceptance or rejection of grafts and transplants. The process and purposes of tissue typing are essentially the same as for blood typing. The major difference lies in the kinds of antigens being evaluated. The acceptance of allografts depends on the hla antigens (HLA); if the donor and recipient are not HLA identical, the allograft is rejected, sometimes within minutes. The HLA genes are located in the major histocompatibility complex, a region on the short arm of chromosome 6, and are involved in cell-cell interaction, immune response, organ transplantation, development of cancer, and susceptibility to disease. There are five genetic loci, designated HLA-A, HLA-B, HLA-C, HLA-D, and HLA-DR. At each locus, there can be any of several different alleles.



Each person inherits one chromosome 6 from the mother and one from the father; that is, each parent transmits to the child one allele for each kind of antigen (A, B, C, D, and DR). If the parents are different at both alleles of a locus, the statistical chance of one sibling being identical to another is one in four (25 per cent), the chance of being identical at one allele only (half-identical) is 50 per cent, and the chance of a total mismatch is 25 per cent.
Techniques for Tissue Typing. Histocompatibility testing involves several basic methods of assay for HLA differences. The most widely used method uses the polymerase chain reaction to compare the DNA of the person, organ, or graft being tested with known pieces of the genes encoding MHC antigens. The variability of these regions of the genes determines the tissue type of the subject.



Serologic methods are used to detect serologically defined antigens on the surfaces of cells. In general, HLA-A, -B, and -C determinants are primarily measured by serologic techniques. A second method, involving lymphocyte reactivity in a mixed lymphocyte culture, for determining HLA-D or lymphocyte-defined antigens, is now only rarely used.

Essentially, the serologic method is performed by incubating target lymphocytes (isolated from fresh peripheral blood) with antisera that recognize all known HLA antigens. The cells are spread in a tray with microscopic wells containing various kinds of antisera and are incubated for 30 minutes, followed by an additional 60-minute complement incubation. If the lymphocytes have on their surfaces antigens recognized by the antibodies in the antiserum, the lymphocytes are lysed. A dye is added to show changes in the permeability of the cell membrane and cellular death. The proportion of cells destroyed by lysis indicates the degree of histologic incompatibility. If, for example, the lymphocytes from a person being tested for HLA-A3 are destroyed in a well containing antisera for HLA-A3, the test is positive for this antigen group.
white adipose tissue (yellow adipose tissue) the adipose tissue composing the bulk of the body fat.

typing

 [tīp´ing]
in transplantation immunology, a method of measuring the degree of organ, solid tissue, or blood compatibility between two individuals, in which specific histocompatibility antigens (such as those on leukocytes or erythrocytes) are detected by means of suitable isoimmune antisera.
blood typing (typing of blood) determining the character of the blood on the basis of agglutinogens in the erythrocytes; see also blood group.
phage typing characterization of bacteria, extending to strain differences, by demonstration of susceptibility to one or more races (a spectrum) of bacteriophage; widely applied to staphylococci, typhoid bacilli, and other organisms for epidemiological purposes.
tissue typing identification of the human leukocyte antigens of the donor and recipient of a transplant or transfusion; see also tissue typing.

tissue typing

a systematized series of tests to evaluate the intraspecies compatibility of tissues from a donor and a recipient before transplantation. Typing is accomplished by identifying and comparing a large series of human leukocyte antigens in the cells of the body. See also immune system, transplant.

tissue typing

The identification of particular chemical groups present on the surface of all body cells and specific to the individual. These groups are called the histocompatibility antigens and include the human leukocyte antigens (HLAs) which are short chains of linked amino acids unique to each person except that they are shared by identical twins. Tissue typing is important in organ donation to reduce the risk of rejection. See also MAJOR HISTOCOMPATIBILITY COMPLEX.

tissue typing,

n a systematic sequence of tests used to determine the compatibility between a recipient and a donor before transplantation; typing is done by identification and comparison of a series of human leukocyte antigens present in the cells.

tissue

a group or layer of similarly specialized cells that together perform certain special functions. For anatomically specific tissues see under their identifying titles, e.g. adipose, connective.

tissue death
tissue density
the penetrability of tissue by x-rays, bone and tooth being most dense, blood and soft tissue the next, fat the next, and gas and air least.
tissue edema
an abnormal accumulation of tissue fluid.
tissue factor
see tissue thromboplastin.
tissue fluid
the extracellular fluid that constitutes the environment of the body cells. It is low in protein, is formed by filtration through the capillaries, and the excess drains away as lymph. See also interstitial fluid.
tissue inhibitors
inhibitors of fibrinolysis; present in placenta.
indifferent tissue
undifferentiated embryonic tissue.
tissue necrosis fever
fever caused by pyrogens released by necrotic pyrogens.
tissue plasminogen activator
see plasminogen activator.
tissue reacting agent
substances that have a poorly defined but advantageous local effect on tissues.
tissue receptor site
a cell receptor common to cells of a particular tissue.
tissue residue
residues of chemical substances that are unacceptable to local pure food legislation especially sulfonamides, estrogens, chlorinated hydrocarbons, heavy metals. These are thought or known to have a deleterious effect on people eating or drinking the relevant animal product. See also chemical food residue.
tissue sensitivity
the susceptibility of individual tissues to injury by x-ray. The injury may be by way of inflammation, necrosis or cessation of cell growth. Fast-growing tissues in which the cells have a high mitotic index are the most sensitive, especially gonads, germinative layer of skin and erythropoietic tissues.
supportive t's
cartilage and bone.
tissue therapy
tissue typing
identification of tissue types for purposes of predicting acceptance or rejection of grafts and organ transplants. The process and purposes of tissue typing are essentially the same as for blood typing. The major difference lies in the kinds of antigens being evaluated. White blood cells, particularly lymphocytes, are used for tissue typing. The acceptance of allografts depends particularly on the matching of MHC antigens. If the donor and recipient are not MHC identical, the allograft is rejected. See also typing.

typing

in transplantation and transfusion immunology, a method of measuring the degree of organ, solid tissue, or blood compatibility between two individuals, in which specific histocompatibility antigens (e.g. those present on leukocytes) or other cell surface antigens, e.g. red blood cell antigens, are detected by means of suitable immune serum.

blood typing
determining the antigenic determinants present on the surface of red blood cells by using specific antibodies (typing serums). See also blood group.
phage typing
see phage typing.
tissue typing
see tissue typing.
References in periodicals archive ?
Terasaki was the first person to devise a method to perform tissue typing and to develop antibodies to be used for tissue typing, UCLA Newsroom reported.
The technique of tissue typing to select embryos for transfer can provide a tissue-matched sibling for an existing child, the authority said.
Prior to that, he served as director of the Transplantation Immunology Laboratory and associate professor of surgery (immunology) at Montefiore Medical Center/Albert Einstein College of Medicine Bronx, New York and associate professor, department of microbiology, associate professor of pathology, and director of the Tissue Typing and Cellular Immunology Laboratory, Medical College of Ohio at Toledo (Toledo, Ohio).
Of the 4 million people who have given blood for tissue typing in the National Bone Marrow Registry, only 300,000 are Latino, Hernandez says.
Together with its CE-marked RealArt(TM) diagnostic kits, artus became one of the first companies world-wide to offer a wide range of Real-Time PCR kits for in vitro diagnostics, including infectiology, oncology, genetic monitoring, tissue typing and control of drug therapies.
In a landmark case Mr Justice Maurice Kay ruled that the HFEA had no legal power to licence embryo selection by tissue typing to help sick siblings.
Nottingham doctors will use tissue typing to ensure there is a chance that the umbilical cord cells match Zain's.
HLA tissue typing is a testing procedure used in matching bone marrow transplants to specific patients.
Its Diagnostics Division develops a large number of specialty products covering three areas: infectious diseases (hepatitis C, hepatitis B, and HIV), genetic testing (HLA tissue typing and cystic fibrosis), and neurodegeneration (Alzheimer's disease).
The latest extension to the scope of UL UK's accreditation as a Notified Body, resulting in complete capability, includes devices that detect Down syndrome in a fetus, the enzyme deficiency that causes phenylketonuria and tissue typing (HLA), which is key for safe and effective organ transplantation.
The process for becoming registered as a potential donor involves paperwork and providing a small sample of blood from one's fingertip for tissue typing.
While tissue typing represents an excellent model system, the advantages of this novel technology will be just as important for other applications requiring simultaneous analysis of moderate to large numbers of DNA sequence variants.

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