P031 Laboratory algorithm for the first cardiac transplant in Panama

Aim The first heart transplant in Panama, made in March 2016, involved two hospitals, the Metropolitan Panama Complex and Punta Pacifica Hospital. The National Transplant Laboratory algorithm included all aspects of immunological compatibility in order to minimize one of the most common complications of transplantation: rejection such as acute heart donor. This paper presents the algorithm developed in the Laboratory in this first heart transplant. Methods The patient is female, 52 years old, blood type “A”. Molecular HLA typing use amplified DNA with specific HLA primer and hybridized with a panel of sequence specific oligonucleotide probes (SSOP) (LIFECODES HLA-SSO-Typing kits) The results of HLA recipient are: A ∗ 02, A ∗ 24, B ∗ 51, B ∗ 58, DRB1 ∗ 04, DRB1 ∗ 13, C ∗ 05, Cw ∗ 15, DQB1 ∗ 03(08), DQB1 ∗ 03(07), DPB1 ∗ 04, DPB1 ∗ 05. The studies to establish the presence of anti-HLA preformed antibodies included LIFECODES Antibody Screen, identification of anti-HLA Class I, II using LIFECODES Class I, II ID, and LIFECODES LSA Class I, II. The patient has in his serum anti-A ∗ 36,anti-B ∗ 14(B64) and anti DQB1 ∗ 02 with PRA Class I and Class II, 4%, 30%. The deceased donor was male, 24 years old, blood “A”, and HLA: A ∗ 02, A ∗ 24, B ∗ 58, B ∗ 63, DRB1 ∗ 13, DRB1 ∗ 13, Cw ∗ 07, C w ∗ 07, DQB1 ∗ 06, DQB ∗ 01. DPB1 01, DPB1 ∗ 02. The virtual Crossmatch was negative and actual crossmatching Test (DSA) was negative (LIFE CODES Donor Specific antibodies). In the Bank Laboratory we keep historical sera of the recipient and the pre-transplant serum and preserve HLA glycoproteins of the deceased donor for future humoral antibody-mediated rejection. Conclusion The time used by the laboratory to complete the algorithm was 4 h and the patient was successfully transplanted. Subsequent studies at 15, 30, 45 days have shown the absence of donor specific antibodies. The Laboratory has developed an algorithm that includes all high-tech procedures that avoid the risk of acute antibody-mediated rejection and guarantee further studies to monitor AMR presence. Final del formulario. Download high-res image (95KB) Download full-size image