Instituto Cardiovascular

Histocompatibility and Immunogenetics Laboratories

FCV Clinical and Molecular Laboratory Unit

The Histocompatibility and Immunogenetics Laboratory Service of the Instituto Cardiovascular of the FCV performs genetic compatibility tests between receptor and donor, as a support to the services of solid organ transplants and family genetic compatibility studies in bone marrow transplants.

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Through the use of different techniques and analytical platforms of the latest technology, highly qualified personnel, and the standardization of processes implemented with high-quality standards, the Histocompatibility Laboratory provides support to patients with chronic renal failure included in the national program of renal transplantation, to which a series of pre-transplant studies are performed to achieve the highest degree of compatibility donor - recipient. In the case of renal transplants, related living donors can be evaluated, and/or tests can be performed with cadaveric donors, for which the laboratory has coverage of zero transplant emergencies, providing timely and reliable results.
 
In bone marrow transplants as a treatment for patients with certain diseases such as leukemias, lymphomas, severe combined immunodeficiencies, myelofibrosis, among others, we perform genetic tests between the patient, and potential donors (siblings and sometimes parents), to determine the compatibility level and then we perform the family haplotype study.
 
The Histocompatibility and Immunogenetics Laboratory has in its portfolio the following tests:
HISTOCOMPATIBILITY TESTING
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HLA CLASS I AND II (A, B, C, DR, DQ) (LUMINEX) MEDIUM HIGH RESOLUTION

The importance of the Histocompatibility Laboratory in the solid organ transplant programs is to carry out the HLA typing to determine the compatibility level that the recipient/donor couple exhibits for the transplant. It is known that the level of HLA compatibility represents a positive effect on kidney transplantation and the decrease of rejection episodes and its impact on the survival of the grafts.

HLA molecular typing is a test that evaluates proteins called human leukocyte antigens (HLA), which are found on the surface of almost every cell in the human body. HLAs are found in large quantities on the surface of white blood cells and help the immune system tell the difference between body tissues and substances not in the body, hence their importance in determining antigenic compatibility between donor and receptor.

The HLA allele identification allows for the selection of donor and receptor compatibility for organ and bone marrow transplant programs. A, B, and DR antigens are the most studied and important in clinical transplantation, which is very useful in the clinical management of the patient, therefore, when the HLA between the recipient and the donor is identical (two haplotypes), this benefit is translated into an increase in the survival of the graft, decrease of rejection episodes, as well as reduction in the number of immunosuppressive drugs. In the case of genetically unrelated individuals such as the cadaveric donor, it is not possible to identify haplotypes and one speaks of the number of antigens or alleles that they share.

Additionally, the HLA test is used to search for alleles associated with autoimmune diseases (ankylosing spondylitis, systemic lupus erythematosus, arthritis, among others).

MOLECULAR BIOLOGY TESTS
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VIRAL LOAD AND DNA DETECTOR FOR CYTOMEGALOVIRUS USING Q-PCR
Human cytomegalovirus (CMV) is a member virus  of the Herpesviridae family, is a significant cause of morbidity and mortality in children and immunosuppressed persons. In the general population, the infection has a significant prevalence, which increases with age until it involves approximately two-thirds of the population. After infection, the virus can remain dormant indefinitely.
 
 
The development of fetal and neonatal medicine, the increase in organ transplants, immunosuppressive treatments, and the prevalence of HIV/AIDS infection has increased the number of patients at risk of developing CMV disease, which in turn has made it necessary to have methodologies to monitor and prevent infection. For this reason, patients are currently followed up by constant clinical evaluation and determination of the viral load for CMV in blood and other sterile fluids and are used in transplanted patients with "pre-symptomatic" antiviral therapy, which should be established based on the results obtained in cytomegalovirus viral load by PCR.

The viral quantification of CMV is recommended for the control and treatment of immunodeficient patients or those who receive immunosuppressive drugs as part of their treatment with transplant and in which Cytomegalovirus can produce serious complications as an opportunistic condition that causes higher morbidity and mortality rates. The viral load is also needed to monitor prophylaxis and preventive or curative treatment with antiviral drugs since Cytomegalovirus is the most important pathogenic agent affecting transplant cases because of its direct correlation with the rejection of the graft or transplanted organ.
 
Likewise, viral load in amniotic fluid is a predictor of intrauterine transmission.