BACKGROUND: To standardize the histocompatibility testing among different laboratories, we have developed and performed a proficiency survey (external quality control) program in HLA typing with participation of nationwide HLA laboratories in Korea. METHODS: During a two-year period, four trials of proficiency survey were performed with 35-39 participating laboratories. Test number and items included in each survey were 3 HLA class Iantigen typings, 2 class II DNA typings, and 6 HLA crossmatch tests (3 cells x 2 sera). RESULTS: HLA class I serological typing was performed on a total of 12 whole blood specimens representing 7 HLA-A and 17 HLA-B antigens. More than 90% of the laboratories correctly identified 7 HLA-A (A2, A3, A11, A24, A26, A30, A33) and 13 HLA-B antigens (B7, B8, B13, B14, B27, B35, B48, B51, B52, B54, B58, B60, B61). Lower consensus (<90%) was obtained for B62, B67, B75, and B15 (B*1511). Considerable difference in antigen detection rate was observed between different commercial trays used. HLA class II DNA typing was performed on a total of 8 DNA specimens representing 13 HLA-DRB1 and 11 DQB1 alleles. For HLA-DRB1 typing (16-26 laboratories), correct assignment rate was very high (98%) for generic level, but lower (80%) for allele level. For DQB1 typing (5-8 laboratories), 100% consensus was obtained for allelic level. With respect to HLA crossmatching, detection rate of incompatibility was very low in the 1st trial. HLA crossmatch workshop on the standardization of typing methods was performed after the 1st trial, and thereafter the number of laboratories using sensitive methods were increased and the detection rate of incompatible crossmatch was much improved (1st 29-46%, 2nd 78-97%). CONCLUSIONS: Through these HLA typing proficiency surveys, standardization of test methods and improvement of typing results were obtained. A continuous survey program would play an important role for improving success rate of organ transplantations in Korea.
Alleles ; Consensus ; DNA ; DNA Fingerprinting ; Education ; Histocompatibility Testing* ; HLA-A Antigens ; HLA-B Antigens ; HLA-DRB1 Chains ; Korea* ; Organ Transplantation ; Transplants

OBJECTIVES: To evaluate pregnancy outcomes after placental needle penetration during midtrimester diagnostic amniocentesis. METHODS: We collected 726 singleton pregnancy cases from 1054 pregnancies of midtrime-ster diagnostic amniocentesis, and analysed pregnancy outcomes after the procedure based on medical records. To compare the outcomes, we divided 726 cases into two groups; placental penetration group by aspiration needle(170 cases) and non-penetration group(556 cases). RESULTS: There were no statistically significant differences between two groups about maternal age and gestational age at the time of procedure, and the distribution of amniocentesis indication. In comparison of complications between two groups after procedure, a. There was no statistically significant difference in amniotic fluid leakage: in penetration group, 1 case (0.58%) and in non-penetration group, 5 cases(0.89%) were observed. b. There was no statistically significant difference in vaginal bleeding: in penetration group, 2 cases (1.18%) and in non-penetration group, 3 cases(0.54%) were observed. c. There was no statistically significant difference in developing abruptio placentae: in penetration group, no case developed and in non-penetration group, one case(0.18%) was observed. d. As for fetal loss, there was no statistically significant difference : in penetration group, 4 cases (2.35%) and in non-penetration group, 10 cases(1.80%) were occurred. e. As for birth weight, there was no statistically significant difference : in penetration group, 3.26+/-0.8 kg and in non-penetration group, 3.21+/-0.9 kg were measured. CONCLUSION: Our study shows that placental penetration by aspiration needle during diagnostic mid-trimester amniocentesis does not increase the risk of post-procedure complication.
Abruptio Placentae ; Amniocentesis* ; Amniotic Fluid ; Birth Weight ; Female ; Gestational Age ; Humans ; Maternal Age ; Medical Records ; Needles* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Uterine Hemorrhage