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
Description Transplant waiting list (TWL) initial patient testing Organs Kidney, Pancreas, Pancreas Islets, Heart, Lung, Liver, Intestine or combined Tests performed - Verification testing
Description Performed at least 1 week after initial TWL testing Organs Kidney, Pancreas, Pancreas Islets, Heart, Lung, Intestine or combined Tests performed HLA Class I + II (A,B,DR) Typing - low resolution (as required) 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. - Monthly sample storage
Description Active patients periodically submit samples so that their HLA antibody levels can be monitored. Organs Kidney, 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 Instructions Please 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
Description Pre-transplant sample collected the day of transplant Organs Kidney, 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
Description For patients returning to the transplant waiting list (TWL) Organs Kidney, Pancreas, Pancreas Islets, Heart, Lung, Liver, Intestine or combined Tests performed
Living Directed Donation (LDD)
- Stage 1 - Virtual cross match
Description Living Directed Donor Transplant (LDD) initial patient and donor testing. A virtual crossmatch assessment based on donors HLA typing and recipient antibodies. Organs Kidney, 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
Special instructions If recipient already worked up for TWL, HLA typing is not required - Stage 2 - Flow crossmatch and verification
Description Living Directed Donor Transplant (LDD) verification patient and donor testing Organs Kidney, Liver Tests performed Recipient
HLA Class I + II (A,B,DR) Typing - low resolution
HLA antibody detection by Luminex (as required)
Donor
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
Description Within month prior to the transplant, a final lymphocyte crossmatch is performed using fresh serum from the patient and lymphocytes from the donor. Organs Kidney, Liver Tests performed Recipient
Donor
Living Non-Directed Donation (LNDD)
- Living Non-Directed Donation (LNDD)
Description Living 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):
- Initial HLA typing - HLA Class I + II (A,B,C,DR,DQ, DP) Typing - high resolution
- Verification HLA typing - HLA Class I + II (A,B,DR) Typing - low resolution
- Lymphocyte crossmatch by flow cytometry (as required)
To coordinate and for more information Contact 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)
Description The 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 information Contact 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)
Description Monitoring for donor specific antibodies (DSA) post transplant Organs Kidney, Pancreas, Pancreas Islets, Heart, Lung, Liver, Intestine or combined Tests performed HLA antibody detection by Luminex
Stem cell transplant
- Initial HLA typing
Description Stem 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
- Verification HLA typing
Description Stem 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 antibody specificity (pre/post-transplant, post-sensitisation)
Description Stem Cell patient HLA antibody testing Tests performed Recipient
HLA antibody detection by Luminex (as required)
- Donor specific antibody desensitisation
Description Stem 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
Special instructions If an auto lymphocyte crossmatch by flow cytometry is required, the laboratory will advise the clinical/transplant unit to ensure required samples are collected.
Related resources
New South Wales (NSW) Solid Organ - Confirmation of Live Donor Renal Transplant Form
Form
Further information
Related topics