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LabCorp and its Specialty Testing Group, a fully integrated portfolio of specialty and esoteric testing laboratories.

LabCorp Transplant Services

Comprehensive solutions for transplant programs

Transplant programs and their health care providers have unique challenges and needs. With a transplant services team, an integrated network of premier specialty testing laboratories, and specimen collection sites, LabCorp is distinctly positioned to serve transplant programs with a goal of improving patient outcomes..

LabCorp employs DNA-based methods to perform testing for either HLA class I (A,B,C) or class II (DR,DQ,DP) loci. LabCorp’s HLA testing is accredited by several agencies, including the American Society for Histocompatibility and Immunogenetics (ASHI) and the College of American Pathologists (CAP).

LabCorp is a contract lab for the National Marrow Donor Program. For more information about the National Marrow Donor Program and becoming a bone marrow donor, go to BeTheMatch.org.

Specialty Transplant Services

LabCorp’s transplant services team ensures clients receive the specialized service and support required for efficient transplant center operation.

  • Dedicated customer service team
  • National courier and logistics network for specimen transport
  • Nearly 2,000 patient service centers conveniently located throughout the US
  • Specimen collection kits
  • Remote donor collections using buccal swab kits
  • Accessible expert consultation
  • Genetic counselors available for consultation
  • Broad menu of clinical and specialty testing

Business Innovation

Through a culture of continual innovation, LabCorp's technology enhances transplant processes, meeting transplant center needs through research and development, information technologies, and business support solutions.

  • Leading edge assay development
  • Interface/Connectivity solutions
  • Web-based ordering and reporting through LabCorp Link
  • Clinical trials and R&D support

Provider Login

Login to order tests for your patients. If you do not have an account, contact sales to get started.

  • HLA Typing Options

    LabCorp employs DNA-based methods to perform HLA typing of Class I (A, B, C) and Class II (DR, DQ, DP) loci. LabCorp uses a diverse network of technology and sequencing platforms to achieve desired resolution.

    Common HLA Genotyping Resolutions

    Antigen Recognition Domain (ARD) level resolution is accomplished with short range sequencing and reports a minimum of G-Group resolution. Common and Well Documented (CWD) level resolution resolves all common nulls and reports high resolution as an allele and/or approved high resolution code. Long-Range Sequencing provides the broadest gene coverage and alleles can be reported at up to four (4) field resolution.

    Class I & II

    Sample Reports

  • Next Generation Sequencing (NGS)

    Next Generation Sequencing (NGS) technology increases the resolution of the HLA typing, while offering a more economical genotyping approach compared to conventional sequencing methods. LabCorp offers NGS typing of all major HLA loci in both ARD/(G-Group) and long read formats, providing options to achieve better resolution, turn-around time, and cost.1

    Alternative short read technologies may suffer from typing ambiguities when heterozygotes include similar alleles. LabCorp’s technology allows for the rapid resolution of these G-Group ambiguities.

    For the highest resolution needs, LabCorp offers third generation long-read sequencing. For HLA class I loci, this assay sequences the entire gene in a single read, eliminating nearly all ambiguities. For Class II loci, the long-read assay covers exons 2, 3 and 4, as well as the intervening intron sequences. LabCorp’s long-read NGS assay provides up to four (4) field resolution and may be reported as an expanded result containing variants within the coding region and polymorphic differences in the non-coding region. All alleles containing differences in gene expression are captured in the final result.

    LabCorp also offers other sequencing methods to expedite turnaround time. For more information please contact your LabCorp representative or call customer service at 800-533-1037 or by email at [email protected]

  • HLA Antibody Detection

    Post-transplant complications have been linked to the presence of pre-existing HLA antibodies.2

    HLA antibody testing detects the antigens in a human leukocyte antigen (HLA) panel that react with a patient’s serum. LabCorp reports calculated panel reactive antibodies (CPRA) which estimate the percentage of potential donors in the population that express one or more of the unacceptable HLA antigens to which a patient has been sensitized.3

    HLA Class I/Class II antibody screening is a qualitative assay that can be used as a means of assessing whether a patient is sensitized to HLA antigens.4 HLA Class I/Class II C1q binding analysis can be performed using single antigen beads to determine which anti-HLA antibodies can bind complement.5

    Clinical Indications

    Testing of individuals in need of either an organ transplant or hematopoietic cell transplant.3,6 Testing of high-risk individuals who may have developed anti-HLA antibodies due to pregnancy, blood transfusion, or previous organ grafts.6 Identification of donor specific antibodies (DSA) in the recipient to assist in donor screening and selection.6 Post-transplant monitoring for the development of donor-specific HLA antibodies.7

    Sample Reports

  • Transplant Engraftment Monitoring (Chimerism testing)

    Transplant Engraftment Monitoring (Chimerism testing)

    Chimerism testing is based on the detection and comparison of alleles at multiple loci in the recipient after transplantation. LabCorp routinely uses 16 loci for detecting differences between recipient and donor, and if the recipient and donor have few or no differences based on routine testing, more loci are available for testing. This testing is informative in most donor/recipient pairs except identical twins. The methodology uses polymerase chain reaction (PCR) to amplify short tandem repeats (STR) of DNA. Cell sorting for post-engraftment monitoring is offered to help physicians evaluate specific cell subpopulations. Cell sorting is available for T cells (CD3), Myeloid cells (CD33/CD66b) and Natural Killer Cells (CD56). LabCorp can also customize assays for other requested cell subpopulations.

    In the example below, the pre-transplant patient (bottom) shows two DNA alleles, 20 and 22. The donor (top) has alleles 21 and 25. Samples taken from the patient after transplant (center) show a mixture of both donor and patient alleles in the CD3 cells, indicating chimerism. The percentage of donor cells is reported — in this case the CD3 cells are 57% donor and the CD33/CD66b cells are 100% donor. The progress of a stem cell transplant can be monitored periodically after transplant, aiding in the diagnosis of disease relapse, graft failure, or successful transplant.

    Sample engraftment monitoring results

    Donor alleles are located at the top of the illustration, the post-transplant CD3 and CD33/CD66b cell fractions are located in the middle, and the bottom panel shows the recipient’s pre-transplant alleles.

    Sample engraftment monitoring results
  • Additional Transplant Services

    Killer Immunoglobulin-like Receptors (KIR): The function of natural killer cells in the immune response is regulated by killer immunoglobulin-like receptors (KIR). These receptors interact with class I HLA antigens on the cell surface to prevent or activate killing of the target cell. KIR genotyping analysis may be useful in some stem cell transplants because KIR matching or mismatching can mediate a graft-versus-leukemia effect when the cancer cells are under-expressing HLA class I antigens.

    ImmuKnow®: ImmuKnow provides information about the immune suppression status of a transplant patient. This assay measures the ATP response of stimulated CD4+ peripheral blood lymphocytes.

    Apolipoprotein L1 Risk Variants: The two apolipoprotein L1 gene (APOL1) risk variants (referred to as G1 and G2), found predominantly in African Americans, have been associated with worse allograft survival in kidney transplantation.11 The homozygous expression of the wild type variant observed in this case has been associated with lower risk of early failure after transplantation compared to kidneys from donors with heterozygous or homozygous expression of the higher risk variants.

    Sample Reports

  • Donor Services

    Private Donor Testing

    For patients in need of a stem cell transplant, the most pressing need it to find a suitable donor. 

    In most cases, family members are screened first LabCorp's Family and Friends program can provide human leukocyte antigen (HLA) typing for potential donors at an affordable price. For more information about setting up a Family and Friends Account, contact LabCorp's histocompatibility customer service Monday through Friday from 8:00am to 6:00pm (EST) and can be reached at 800-533-1037 or by email at [email protected].

    Patient Service Centers

    • Network of nearly 2,000 patient service centers
      • LabCorp can accommodate donor collections throughout the country and can support remote collection with buccal swab kits for self-collection.
      • Strategically located sites throughout the United States to provide convenient access to specimen collection services

    Quality Assurance

    • Our staff is committed to providing a professionalenvironment during the specimen collection process.
    • Cost effective solutions for screening and confirmatory typing of patients and donors
    • Fully licensed and accredited: CAP, ASHI, ISO 17025, CLIA
    • Network-wide quality control analysis
    • Standardized laboratory technology and protocols
    • Internal and external proficiency testing program

Customer Services & Expert Consultation

LabCorp’s histocompatibility staff is dedicated to assisting with questions regarding histocompatibility testing and transplant-related services. LabCorp’s scientists are also available to answer questions and consult with transplant center staff.

This dedication ensures that the transplant center team receives personal and timely resolution to their questions or concerns. LabCorp’s customer service representatives are available Monday through Friday from 8:00am to 6:00pm (EST) and can be reached at 800-533-1037 or by email at [email protected].

References

  1. Schofl G, Lang K, Quenzel P, et al. 2.7 million samples genotyped for HLA by next generation sequencing: lessons learned. BMC Genomics. 2017; 18:161.
  2. Hadjiliadis D, Chaparro C, Reinsmoen NL, et al. Pre-transplant panel reactive antibody in lung transplant recipients is associated with significantly worse post-transplant survival in a multicenter study. J Heart Lung Transplant. 2005;24 (7 Suppl):249-54.
  3. Mishra MN, Baliga KV. Significance of panel reactive antibodies in patients requiring kidney transplantation. Saudi Journal of Kidney Diseases and Transplantation. 2013;24:3:495-499.
  4. Cecka JM. Calcuated PRA (CPRA): The new measure of sensitization for transplant candidates. Am Journal of Transplantation. 2010;10: 26-29.
  5. Chen G, Tyan DB. C1q assay for the detection of complement fixing antibody to HLA antigens. Methods Mol Biol. 2013;1034: 305-11.
  6. Spellman S, Bray R, Rosen-Bronson S, Haagenson M, Klein J, et al. Donor-directed, HLA alloantibodies and graft failure. Blood. 2010; 115:2704-2708.
  7. Kauke T, Oberhauser C, Lin V, et al. De novo donor-specific anti-HLA antibodies after kidney transplantation are associated with imparied graft outcome independently of their C1q-binding ability. Transplant International. 2017;30:360-370.
  8. Kobashigawa JA, Kiyosaki KK, Patel JK, et al. Benefit of immune monitoring in heart transplant patients using ATP production in activeated lymphocytes. J Heart Lung Transplant. 2010;29:504-508.
  9. Kowalski RJ, Post DR, Mannon RB, et al. Assessing relative risks of infection and rejection: a meta-analysis using an Immune Function Assay. Transplantation. 2006:82:663-668.
  10. De Paolis P, Favaro A, Piola A, et al. “ImmuKnow” to measurement of cell-mediated immunity in renal transplant recipients undergoing short-term evaluation. Transplant Proceedings. 2011;43:1013-1016.
  11. Reeves-Daniel AM, DePalma JA, Bleyer AJ, et al. The APOL1 gene and allograft survival after kidney transplantation. Am J Transplant. 2011 May;11(5):1025-1030.

ImmuKnow® is a trademark of Viracor-IBT Laboratories Inc. Lee's Summit, Mo.