In a lab most people will never see, a team of specialists is quietly matching donor organs and stem cells to patients in need of transplants.
As part of
UHN's Laboratory Medicine Program, the Transplant Immunology Lab, formally known as the Histocompatibility and Immunogenetics Laboratory (HLA Lab), combines science, precision and care to ensure every organ and stem cell transplant at UHN is safe before a surgery moves forward.
The work is fast — often happening overnight — and meticulous. Without the lab's immunological testing and human leukocyte antigens (HLA) matching, a transplanted organ or stem cell risks rejection by the recipient's immune system, causing severe and even life-threatening complications.
"We find the best donor for our patient population so that they'll have the longest, most successful transplant possible," says Dr. Jeffrey Kiernan, assistant director of the Transplant Immunology Lab.
"Each year, our team supports over 900 solid organ transplants and over 200 stem cell transplants, from kidneys and lungs to cutting-edge procedures like stem cell transplants."
The work underpins the life-saving procedures at UHN's
Ajmera Transplant Centre, Canada's largest and most comprehensive transplant program, recognized for its world-class care.
How donor organs, stem cells are matched with patients
Together, the lab's team of directors, lab technologists, medical lab assistants and administrative staff use highly specialized laboratory processes and tools to determine whether a donor organ can be safely accepted by a patient.
At the core of the lab's work is the analysis of HLA — tiny protein "ID tags" on the surface of cells that help your immune system know the difference between what belongs in your body and what does not.
The lab process begins by testing DNA samples to determine the HLA tags of both the donor and patient.
"In transplant medicine, these immune markers are everything. The better the HLA match, the higher the chance of a successful transplant," says Dr. Kiernan.
The HLA matchmaking process for solid organ transplants works differently. Through a combination of molecular testing and HLA typing, antibody screening and cross-matching, the team not only determines whether a donor and recipient are compatible, but also whether a recipient has antibodies that would attack a specific donor organ.
"With solid organ transplants, we're not looking for a perfect match in the sense that they're identical," says Michael Naglich, supervisor and former senior laboratory technologist in the lab.
"We're looking for recipients that do not have opposing antibodies. We're also checking HLA markers to look for a donor that doesn't trigger a harmful immune response when matched with the patient's HLA markers. That's what makes a transplant safe."
