Transplant testing

Patients requiring an organ or combined organ transplant can be tested and registered for a deceased organ donor, or live organ donor (renal, liver only). 

Patients with haematological and other blood disorders may require an allogeneic (non-self) stem cell transplant from a family member or an unrelated donor. 

Click on the links below for further information on these tests including specimen requirements and turnaround times
 

Solid organ transplant

Transplant waiting list (TWL)

Initial testing
DescriptionTransplant waiting list (TWL) initial patient testing
OrgansKidney, Pancreas, Pancreas Islets, Heart, Lung, Liver, Intestine or combined
Tests performed

HLA Class I + II (A,B,C,DR,DQ,DP) Typing - high resolution 

HLA antibody detection by Luminex

Verification testing
DescriptionPerformed at least 1 week after initial TWL testing
OrgansKidney, Pancreas, Pancreas Islets, Heart, Lung, Intestine or combined
Tests performedHLA Class I + II (A,B,DR) Typing - low resolution (as required)
Special instructionsSamples for verification typing are to be collected on separate days to initial typing samples wherever possible but must be collected at different collection time points.
Monthly sample storage
DescriptionActive patients periodically submit samples so that their HLA antibody levels can be monitored.
OrgansKidney, Pancreas, Pancreas Islets, Heart, Lung, Intestine or combined
Tests performed

Most samples are stored only

Every third sample - HLA antibody detection by Luminex (as required)

Special InstructionsPlease notify relevant laboratory of any sensitising events or changes to immunosuppression by adding medical event information to OM. Further HLA antibody will be performed as required.
Day of transplant
DescriptionPre-transplant sample collected the day of transplant
OrgansKidney, Pancreas, Pancreas Islets, Heart, Lung, Liver, Intestine or combined
Tests performed

Samples are stored and tested upon request

HLA antibody detection by Luminex (as required)

Re-entry testing
DescriptionFor patients returning to the transplant waiting list (TWL)
OrgansKidney, Pancreas, Pancreas Islets, Heart, Lung, Liver, Intestine or combined
Tests performed

HLA typing (if required)

HLA antibody detection by Luminex

 

Solid organ transplant

Living Directed Donation (LDD)

Stage 1 - Virtual cross match
DescriptionLiving Directed Donor Transplant (LDD) initial patient and donor testing. A virtual crossmatch assessment based on donors HLA typing and recipient antibodies.
OrgansKidney, Liver
Tests performed

Recipient

HLA Class I + II (A,B,C,DR,DQ, DP) Typing - high resolution

HLA antibody detection by Luminex

Eplet Analysis, as required

Donor

HLA Class I + II (A,B,C,DR,DQ, DP) Typing - high resolution

Special instructionsIf recipient already worked up for TWL, HLA typing is not required
Stage 2 - Flow crossmatch and verification
DescriptionLiving Directed Donor Transplant (LDD) verification patient and donor testing
OrgansKidney, Liver
Tests performed

Recipient

HLA Class I + II (A,B,DR) Typing - low resolution

HLA antibody detection by Luminex (as required)

Donor

Lymphocyte crossmatch by flow cytometry

HLA Class I + II (A,B,DR) Typing - low resolution

Special instructions

Samples for verification typing are to be collected on separate days to initial typing samples wherever possible but must be collected at different collection time points.

Samples sent for crossmatching prior to living renal transplantation must be pre-booked. Please email the laboratory (see contact details).

If an auto lymphocyte crossmatch by flow cytometry is required, the laboratory will advise the clinical/transplant unit to ensure required samples are collected.

If recipient already worked up for TWL, HLA typing is not required.

Stage 3 - Final crossmatch
DescriptionWithin month prior to the transplant, a final lymphocyte crossmatch is performed using fresh serum from the patient and lymphocytes from the donor.
OrgansKidney, Liver
Tests performed

Recipient

HLA antibody detection by Luminex 

Donor

Lymphocyte crossmatch by flow cytometry

 

Living Non-Directed Donation (LNDD)

Living Non-Directed Donation (LNDD)
DescriptionLiving Non-Directed Donor (LNDD) donor testing performed for a person who would like to donate their kidney altruistically.
Tests performed

Testing requirements are equivalent to a living directed donor however a crossmatch is not performed until a recipient is identified via The Australian & New Zealand Kidney eXchange (ANZKX) program or via donation to the transplant waiting list (TWL):

To coordinate and for more informationContact the relevant laboratory or refer to https://www.donatelife.gov.au/for-healthcare-workers/ANZKX for further information

 

Kidney Paired Donation (KPD/ANZKX)

Kidney Paired Donation (KPD/ANZKX)
DescriptionThe Australian & New Zealand Kidney eXchange (ANZKX) program is designed to increase living donor kidney transplants by identifying matches for incompatible donor-recipient pairs. 
Tests performed

Testing requirements vary depending on the stage of recipient/donor workup but can include:

  • HLA typing 
  • HLA antibody detection by Luminex
  • Lymphocyte crossmatch by flow cytometry 
To coordinate and for more informationContact the relevant laboratory or refer to https://www.donatelife.gov.au/for-healthcare-workers/ANZKX for further information

 

Post-transplant testing (Donor Specific Antibody - DSA)

Post-transplant testing (Donor Specific Antibody - DSA)
DescriptionMonitoring for donor specific antibodies (DSA) post transplant
OrgansKidney, Pancreas, Pancreas Islets, Heart, Lung, Liver, Intestine or combined
Tests performedHLA antibody detection by Luminex

 

Stem cell transplant

Initial HLA typing
DescriptionStem Cell transplant initial patient/donor testing
Tests performed

Recipient

HLA Class I + II (A,B,C,DR,DQ, DP) Typing - high resolution

Or

HLA Class I + II (A,B,DR) Typing - low resolution

HLA antibody detection by Luminex (as required)

Donor

Will depend if haplotype or matched transplant:

HLA Class I + II (A,B,C,DR,DQ, DP) Typing - high resolution

Or 

HLA Class I + II (A,B,DR) Typing - low resolution

Verification HLA typing
DescriptionStem Cell transplant verification patient/donor testing
Tests performed

Recipient

HLA Class I + II (A,B,C,DR,DQ, DP) Typing - high resolution

Or 

HLA Class I + II (A,B,DR) Typing - low resolution

HLA antibody detection by Luminex (as required)

Donor

Will depend if haplotype or matched transplant:

HLA Class I + II (A,B,C,DR,DQ, DP) Typing - high resolution

Or 

HLA Class I + II (A,B,DR) Typing - low resolution

HLA antibody specificity (pre/post-transplant, post-sensitisation)
DescriptionStem Cell patient HLA antibody testing
Tests performed

Recipient

HLA antibody detection by Luminex (as required)

Donor specific antibody desensitisation
DescriptionStem cell transplant workup for HLA mismatched / haploidentical stem cell transplant in the presence of donor specific antibodies (DSA)
Tests performed

Recipient

HLA antibody detection by Luminex (as required)

Donor

Lymphocyte crossmatch by flow cytometry

Special instructionsIf an auto lymphocyte crossmatch by flow cytometry is required, the laboratory will advise the clinical/transplant unit to ensure required samples are collected.

 

New South Wales (NSW) Solid Organ Transplant Request Form thumbnail

New South Wales (NSW) Solid Organ Transplant Request Form

Form
South Australia (SA) Solid organ request form

South Australia (SA) Solid organ request form

Form
Sample and Volume Requirements Form

Sample and Volume Requirements Form

Form
New South Wales (NSW) Solid Organ - Confirmation of Live Donor Renal Transplant Form

New South Wales (NSW) Solid Organ - Confirmation of Live Donor Renal Transplant Form

Form
New South Wales (NSW) Stem cell transplant request form

New South Wales (NSW) Stem cell transplant request form

Form
South Australia (SA) Tissue Typing Services Request Form

South Australia (SA) Tissue Typing Services Request Form

Form
VIC International Request Form Buccal Collections thumbnail

VIC International Request Form - Buccal Collections

Form
NSW Buccal Swab HLA Typing Request Form thumbnail

NSW Buccal Swab HLA Typing Request Form

Form
SA Buccal Swab HLA Typing Request Form thumbnail

SA Buccal Swab HLA Typing Request Form

Form

Further information