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Blood test
Blood test
Bone Tissue
Bone Tissue

Histocompatibility antigens
Definition:
A blood test that determines a person's major histocompatibility antigens.

Alternative Names:
HLA typing; Tissue typing

How the test is performed:
Adult or child:
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic, and a tourniquet (an elastic band) or blood pressure cuff is placed around the upper arm to apply pressure and restrict blood flow through the vein. This causes veins below the tourniquet to distend (fill with blood). A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the tourniquet is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

Infant or young child:
The area is cleansed with antiseptic and punctured with a sharp needle or a lancet. The blood may be collected in a pipette (small glass tube), on a slide, onto a test strip, or into a small container. Cotton or a bandage may be applied to the puncture site if there is any continued bleeding.
How to prepare for the test:
Adults:
No preparation is necessary.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:
How the test will feel:
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.
Why the test is performed:

HLA (human leukocyte antigens) are proteins present in the cell membranes of nearly every cell in the body (all nucleated cells). These antigens are in especially high concentrations on the surface of white blood cells (leukocytes).

HLA antigens are the major determinants used for by the body's immune system for recognition and differentiation of self from non-self. There are many different major histocompatibility (HLA) proteins and an individual possesses only a small, relatively unique set that is inherited from their parents. It is unlikely that 2 unrelated people will have the same HLA make-up. Children, on average, will have one-half of their HLA antigens that match one-half of their mothers antigens; the other one-half of the child's antigens will match one-half of their father's antigens. This is particularly important in identifying good "matches" for tissue grafts and organ transplants, such as a kidney transplant or bone marrow transplant.

Many HLA molecules exist, but some are of special interest because they are more common in certain autoimmune diseases. For example, HLA-B27 antigen is found in 80 to 90% of people with ankylosing spondylitis and Reiter's syndrome, and can aid in the diagnosis of these diseases. However, HLA-B27 is also present in 5 to 7% of people without autoimmune disease. Thus, the mere presence of this HLA molecule is not indicative of disease by itself.

HLA types can also used to determine relationships between children and parents when such relationships are in question. However, newer genetic testing is now available supplanting the use of the test for this purpose.
Normal Values:
Each person has unique HLA antigens (although identical twins may match each other).
What abnormal results mean:
Each person has unique HLA patterns. However, some HLA types are associated with certain conditions (see "Why is the test performed").
What the risks are:
  • excessive bleeding
  • fainting or feeling light-headed
  • hematoma (blood accumulating under the skin)
  • infection (a slight risk any time the skin is broken)
  • multiple punctures to locate veins
Special considerations:
Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.
Review Date: 11/19/2001
Reviewed By: Michael C. Milone, M.D., Ph.D., Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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