MAJOR HISTOCOMPATIBILITY COMPLEX Histocompatibility Antigen In humans, the proteins coded by the genes of the major histocompatibility complex

(MHC) include human leukocyte antigens (HLA), as well as other proteins. HLA proteins are present on the surface of most of the body's cells and are important in helping the immune system distinguish 'self' from 'non-self'.

Nomenclature of HLA Alleles Each HLA allele name has a unique number corresponding to up to four sets of digits separated by colons. The length of the allele designation is dependant on the sequence of the allele and that of its nearest relative. All alleles receive at least a four digit name, which corresponds to the first two sets of digits, longer names are only assigned when necessary. The digits before the first colon describe the type, which often corresponds to the serological antigen carried by an allotype, The next set of digits are used to list the subtypes, numbers being assigned in the order in which DNA sequences have been determined. Alleles whose numbers differ in the two sets of digits must differ in one or more nucleotide substitutions that change the amino acid sequence of the encoded protein. Alleles that differ only by synonymous nucleotide substitutions (also called silent or non-coding substitutions) within the coding sequence are distinguished by the use of the third set of digits. Alleles that only differ by sequence polymorphisms in the introns or in the 5' or 3' untranslated regions that flank the exons and introns are distinguished by the use of the fourth set of digits. In addition to the unique allele number there are additional optional suffixes that may be added to an allele to indicate its expression status. Alleles that have been shown not to be expressed, 'Null' alleles have been given the suffix 'N'. Those alleles which have been shown to be alternatively expressed may have the suffix 'L', 'S', 'C', 'A' or 'Q'. The suffix 'L' is used to indicate an allele which has been shown to have 'Low' cell surface expression when compared to normal levels. The 'S' suffix is used to denote an allele specifying a protein which is expressed as a soluble 'Secreted' molecule but is not present on the cell surface. A 'C' suffix to indicate an allele product which is present in the 'Cytoplasm' but not on the cell surface. An 'A' suffix to indicate 'Aberrant' expression where there is some doubt as to whether a protein is expressed. A 'Q' suffix when the expression of an allele is 'Questionable' given that the mutation seen in the allele has previously been shown to affect normal expression levels.

MHC class I proteins form a functional receptor on most nucleated cells of the body.

There are 3 major and 3 minor MHC class I genes in HLA: HLA-A HLA-B HLA-C minor genes are HLA-E, HLA-F and HLA-G 2-microglobulin binds with major and minor gene subunits to produce a heterodimer There are 3 major and 2 minorMHC class II proteins encoded by the HLA. The genes of the class II combine to form heterodimeric () protein receptors that are typically expressed on the surface of antigen-presenting cells. Major MHC class II HLA-DP -chain encoded by HLA-DPA1locus -chain encoded by HLA-DPB1locus HLA-DQ -chain encoded by HLA-DQA1 locus -chain encoded by HLA-DQB1 locus HLA-DR -chain encoded by HLA-DRA locus 4 -chains (only 3 possible per person), encoded by HLADRB1, DRB3, DRB4, DRB5loci The other MHC class II proteins, DM and DO, are used in the internal processing of antigens, loading the antigenic peptides generated from pathogens onto the HLA molecules of antigen-presenting cell. Complement-Mediated Cytotoxicity Class I antigens are determined by several techniques; the popular classic method is lymphocyte microcytotoxicity method with this technique which a battery of reagent antisera and isolated target cell are incubated with a source of complement under oil to prevent evaporation For HLA class I typing or anti-class I antibdy identification, the purified T-cell population is preffered because human T lymphocyte express class I not class II molecules.

Solid-Phase Enzyme-Linked Immunosorbent Assay Enzyme linked immunosorbent assay (ELISA) is available for panel-reactive antibody (PRA) determination and antibody-specificity analysis. ELISA-based HLA test are considered reproducible, sensitive, and objective. Newer assay use pure HLA antigens produced by recombinant technology to improve specificity analysis.

Flow cytometry

- is a technique for counting and examining microscopic particles, such as cells and chromosomes, by suspending them in a stream of fluid and passing them by an electronic detection apparatus. It allowssimultaneous multiparametric analysis of the physical and/or chemical characteristics of up to thousands of particles per second. Flow cytometry is routinely used in the diagnosis of health disorders, especially blood cancers, but has many other applications in both research and clinical practice. A common variation is to physically sort particles based on their properties, so as to purify populations of interest. FACTS ABOUT SOLID ORGAN TRANSPLANTATION Organ transplantation is widely viewed as the preferred treatment for end-stage organ failure because of the quality of life the treatment offers for patients and because of long-term cost benefits. The increased demand for organ transplantation is fueled by the transplant rate. Factor on how long a patients wait for a transplant -blood type -tissue type -height and weight of transplant candidate -Sized of donated organ -Medical urgency -Time on the waiting list -Distance between donors hospital and potential donor organ -Number of donors in local area over time -Transplant criteria for accepting organ offer Most common reasons for needing a transplant vary by the type of organ. -Kidney- diabetes, glomerulonephritis, hypertensive nephrosclerosis or polycystic kidney -Liver- cholestatic liver disease, acute hepatic necrosis r hepatitis C -Heart- valvular heart disease or coronary artery disease