BACKGROUND: HLA proficiency survey in Korea started in 1996 and the results of the survey were last reported in 1999. In this report, we summarized the results of the survey performed in recent 2 years. METHODS: A total of four proficiency surveys were performed, in which 54-59 laboratories participated. Each survey included 3 tests for HLA class I (serology and DNA) and class II (DNA) typing and 6 for HLA crossmatch test (3 cells x 2 sera). RESULTS: Overall concordance of serologic typing was 99.5% (436/438) for HLA-A, 95.7% (419/438) for HLA-B, and 94.8% (199/210) for HLA-C. The antigens assigned incorrectly by more than 5% of the participating laboratories were B54 (10.3%), B55 (10.3%), B27 (5.4%), Cw6 (22.9%), and C-blank (5.7%). Overall concordance rates of DNA typing were 99.7% (393/394) for HLA-A, 99.8% (415/416) for HLA-B, 100% (156/156) for HLA-C. Correct assignment of HLA-DRB1 and -DQB1 was reportred by 99.7% (98.1-100%) and 99.2% (88.9-100%) for generic and 99.2% and 98.1% (80-100%) for allelic level, respectively. Most laboratories (93.5-97.9%) were using sensitive methods of crossmatch such as T-long, T-AHG, and flowcytometry. The proportion of laboratories evaluated as unacceptable was on the average 3.1% of total laboratories. CONCLUSIONS: The rate of correct identification of HLA antigens was higher this time than in the previous survey in 1999. The rate of unacceptable crossmatch was also low enough to be satisfactory. It is thought that the proficiency survey has contributed to the high quality of HLA tests in the participating laboratories and should be continued to maintain the proficiency in Korea.
DNA Fingerprinting ; Histocompatibility Testing* ; HLA Antigens ; HLA-A Antigens ; HLA-B Antigens ; HLA-C Antigens ; HLA-DRB1 Chains ; Korea

BACKGROUND: HLA proficiency survey was started in 1996 in Korea, and the results of the 1996-1998 surveys were reported previously. Here, we report the results of the surveys performed in recent three years (2000-2002). METHODS: Six surveys were carried out with the participation of 52-54 laboratories. For each survey, 3 peripheral blood samples and 2 sera were distributed for 3 HLA class I serology, 3 HLA class I DNA, 3 HLA class II DNA, 6 HLA crossmatch, and 3 PRA tests. RESULTS: Overall consensus of serologic typing was similar to the results of the previous survey: HLA-A 93.5%, HLA-B 88.3%, and HLA-A, B 82.7%. There were an increasing number of the laboratories that were using DNA typing for HLA-DR (51 laboratories, 94%) and HLA-A and B (26 laboratories, 48%). Overall consensus of DNA typing was very high: HLA-A 100%, HLA-B 99.1%, HLAC 97.9%, HLA-DRB1 low/high resolution 99.2/99.0%, HLA-DQB1 low/high resolution 99.3/97.5%. HLA crossmatch (T cells) was reported by 44-49 laboratories, and the use of sensitive methods was increased: AHG 33 laboratories and flow cytometry 7 laboratories. For incompatible (positive) crossmatches, 4.9% (0-14.3%) of cytotoxicity tests and 7.1% (0-16.7%) of flow tests were reported as negative. PRA was reported by 5 laboratories only. CONCLUSIONS: The use of DNA tests for HLA typing and AHG or flow cytometry methods for HLA crossmatch tests has much increased compared to the previous report. A continuous survey program would play an important role in the standardization and maintenance of laboratory proficiency in histocompatibility testing in Korea.
Consensus ; DNA ; DNA Fingerprinting ; Flow Cytometry ; Histocompatibility Testing* ; HLA-A Antigens ; HLA-B Antigens ; HLA-DR Antigens ; HLA-DRB1 Chains ; Korea

To determine the possible participation of genetic factors in the pathogenesis of Takayasu's arteritis and to investigate an association between HLA antigens and the disease, we performed HLA typing in twenty two patients confirmed by clinical findings and aortography, and in fifty normal Koreans as controls. HLA-A, B,C and DR antigens were tested by standard microlymphocytotoxicity method with HLA antisera, which were supplied by UCLA Tissue Typing Laboratory. The results were as follows: 1) Frequent antigens of HLA-A locus in patients were A 2(54.5%), Aw 33(31.8%), Aw 24(27.2%) and A26(13.6%) in decreasing order, and Aw 33 was more frequent in patients than in normal controls(18.0%)(relative risk: 2.1). 2) Frequent antigens of HLA-B locus in patients were Bw61(31.8%), Bw44(31.8%), Bw62(22.7%) and Bw52(13.6%) in decreasing order, and Bw61 was more frequent in patients than in normal controls(10%)(relative risk : 4.2). 3) Frequent antigens of HLA-C locus in patients were Cw3(54.5%), Cw6(50.0%) and Cw1(22.7%) in decreasing order. 4) Frequent antigens of HLA-DR locus in patients were DR6Y(36.4%), DR2(31.8%), DRw9(27.2%), DR4(27.2%) and DR28(22.7%) in decreasinng order. In MT system MT 3 was more frequent in patients(54.5%) than in normal controls(31.6%)(relative risk : 2. 6). However, the difference of HLA antigen frequencies between patients and normal controls was not statistically significant, and the association of specific HLA antigens with Takayasu's arteritis requires further studies to be confirmed.
Aortography ; Histocompatibility Testing ; HLA Antigens* ; HLA-A Antigens ; HLA-B Antigens ; HLA-C Antigens ; HLA-DR Antigens ; Humans ; Immune Sera ; Takayasu Arteritis*

BACKGROUND: HLA-B27 typing has long been performed by the microlymphocytotoxicity method(MCT) but the flow cytometry method(FCM) was introduced several years ago. False positive results due to the HLA-B7 cross reactive groups(CREG) were the main drawback of the serologic method. The authors performed polymerase chain reaction-sequence specific primer(PCR-SSP) test for HLA-B27 to compare the results with serologic methods. METHODS: PCR-SSP test for HLA-B27 was performed on four hundred forty one samples. Three hundred twenty eight samples were tested by MCT and one hundred thirteen samples by FCM. PCR-SSP for HLA-B27 subtyping or Amplification Refractory Mutation System-PCR(ARMS-PCR) for HLA-B typing was performed on twenty four discrepant samples. RESULTS: The concordance rate between MCT and PCR-SSP was 92.9%(305/328) and the concordance rate between FCM and PCR-SSP was 99.1%(112/113). Twenty four(5.4%) out of four hundred forty one samples showed discrepancy between serologic methods and PCR-SSP method. Fourteen out of one hundred MCT positive samples and only one out of forty FCM positive samples showed negative by PCR-SSP. Nine samples showed PCR-SSP positive and MCT negative. CONCLUSIONS: The false positive rate of MCT was quite high and there were some false positive and negative results by PCR-SSP, too. From the above findings, we suggest that FCM is the most accurate method for HLA-B27 typing in those laboratory equipped with flow cytometry.
Flow Cytometry* ; HLA-B Antigens ; HLA-B27 Antigen* ; HLA-B7 Antigen

Objective:b> To analyze family-based haplotype frequencies of HLA-A, -B, -C, -DRB1 and -DQB1 genes and their clinical significance. Methods:b> The data of HLA genotyping in 3568 families undergoing related haploidentical transplantation between 2012 and 2017 at the First Affiliated Hospital of Soochow University were retrospectively evaluated. The HLA genotyping was performed by PCR amplification with sequence-based typing (PCR-SBT) and sequence-specific oligonucleotide probe (PCR-SSOP) methods. The family genetic analysis and haplotype frequencies were also investigated. Results:b> All the families were divided into 3 groups, including group1 of 1 422 entire families; group2 of 1 310 patients and either of their parents or one of their children; group3 of 836 patients and their HLA≥5/10 matched sibling donors. In the haplotypes with frequencies greater than 0.1% in group1+ group2, the frequency of A*11∶01-B*40∶01-C*03∶04-DRB1*11∶01-DQB1*03∶01, A*02∶07-B*51∶01-C*14∶02-DRB1*09:01-DQB1*03∶03 were significantly different between group1 and group2 (P=0.029, 0.033) . The frequency of A*11∶01-B*46∶01-C*01∶02∶01G-DRB1*09∶01-DQB1*03∶03 was significantly different between group1 and group3 (P=0.035) . The frequency of A*02∶01-B*40∶01-C*07∶02-DRB1*09∶01-DQB1*03∶03 was significantly different between group1 and group2 (P=0.034) , or group1 and group3 (P=0.034) . The frequency of A*24∶02-B*13∶01-C*03∶04-DRB1*12∶02-DQB1*03:01 was significantly different between group2 and group3 (P=0.046) . Conclusion:b> In this study, we summarize the prevalence of haplotype frequencies in terms of HLA-A, -B, -C, -DRB1 and-DQB1. Based on the database of family haplotype analysis, patients and donor candidates are sorted with matched HLA genotype while unmatched HLA haplotype. Even in patients without entire family information, HLA haplotype analysis assists in choosing the optimal related or unrelated donors.
Alleles ; Child ; Gene Frequency ; HLA-A Antigens ; HLA-B Antigens ; HLA-C Antigens ; HLA-DQ beta-Chains ; HLA-DRB1 Chains ; Haplotypes ; Humans ; Retrospective Studies

There still is debates on the effect and the value of HLA matching on graft survival in clinical renal transplantation. A few reports were presented in Korea about the effect, where over 95% of kidneys have been taken from living donor, and the results are inconclusive. So, we analysed 329 cyclosporine treated first living donor renal transplantation performed in Keimyung University Dongsan medical center, from Nov. 1982 to Feb. 1996 to determine the effect of HLA matching on graft outcome. Significant survival benefits were observed at 5 years between HLA-B 0 mismatch(MM) and more than 0 MM (89.73% vs 64.68, 60.26%, p<0.05), A+B 0 MM and more than 0 MM(94.28% vs 63.94, 63.43, 56.25%, p<0.05), B+DR 0 MM and 2, 3 MM(89.59% vs 61.82, 64.98%, p<0.05), and A+B+DR 0 MM and 3, 4 MM(92.57% vs 56.82, 63.19%, p<0.05). But HLA-A or DR mismatch alone seemed to have no effect on graft survival. Our results showed some beneficial effect of HLA match on renal graft survival but yet inconclusive due to small size of the number.
Cyclosporine* ; Graft Survival* ; HLA-A Antigens ; HLA-B Antigens ; Humans ; Kidney ; Kidney Transplantation* ; Korea ; Living Donors* ; Transplants*

BACKGROUND: Transfusion of HLA-matched platelets is required when development of platelet refractoriness occurs after repeated platelet transfusion. This study was conducted to establish a HLA-matched platelet donor registry to supply matched platelets to patients who develop platelet refractoriness. METHODS: HLA-matched platelet donors were recruited among plateletpheresis donors. HLA-A and HLA-B antigen types of recruited donors were tested using a polymerase chain reaction-sequence specific oligonucleotide probe method. RESULTS: A total of 1,029 plateletpheresis donors were recruited. HLA-A and HLA-B antigen frequencies of recruited donors were similar to those of previously reported HLA antigen frequencies of Koreans. During the study period, a patient with platelet refractoriness recovered after receiving six units of HLA-matched platelets. CONCLUSION: During this study 1,029 donors were registered as HLA-matched platelet donors and a patient with platelet refractoriness received HLA-matched platelets using this registry. Supply of HLA-matched platelets will be facilitated by continuous expansion of the number of registered HLA-matched platelet donors, development of a program for management and searching for HLA-matched donors, and establishment of a request-supply system between hospitals and the Korean Red Cross through further studies.
Blood Platelets* ; HLA-A Antigens ; HLA-B Antigens ; Humans ; Platelet Transfusion ; Plateletpheresis ; Red Cross* ; Tissue Donors*

Serological mistypings of HLA-A and HLA-B in 27 cases were analyzed. The results showed that for HLA-A and HLA-B typing, the rates of incorrect antigen assignments were significantly higher than rates of antigen misses (P < 0.05), but there was no significant difference between HLA-A and HLA-B typings. The frequencies of miss-assigned HLA-A and HLA-B specificities were A1 (66.7%), A3 (50.0%), A11 (13.5%), A9 (11.8%), A19 (7.1%), and B16 (50.0%), B48 (43.9%), B15 (16.7%), B40 (11.1%), B13 (10.0%) and B17 (9.1%). In conclusion, the serologic and DNA-based typing techniques should be reciprocally complementary in HLA-A and HLA-B typing.
Asian Continental Ancestry Group ; China ; HLA-A Antigens ; classification ; genetics ; HLA-B Antigens ; classification ; genetics ; Humans ; Serotyping

BACKGROUND: To monitor the performance of histocompatibility testing laboratories, HLA proficiency survey in Korea has been conducted biannually since 1996. In this report, we summarized the results of the surveys performed in recent two years (2005-2006). METHODS: A total of four proficiency surveys were performed, in which 59-61 laboratories participated. Each survey included three tests for HLA class I (serology and DNA) and class II (DNA) typing and six tests for HLA crossmatch. RESULTS: The overall concordance of serologic typing was 98.9% (355/359) for HLA-A, 97.5% (350/ 359) for HLA-B, and 94.7% (337/356) for HLA-C. The antigens assigned correctly by less than 95% of the participating laboratories were A26 (93.8%), B38 (94.2%), Cw3/Cw10 (90.9%), Cw6 (94.4%), and Cw8 (74.3%). The overall concordance rates of DNA typing were 99.6% (533/535) for HLA-A, 99.8% (539/540) for HLA-B, and 100% (392/392) for HLA-C. Correct assignment of HLA-DRB1 and -DQB1 was reported by 99.2% (98.1-100%) and 96.7% (88.9-100%) for the generic level and 100% and 95.8% (75-100%) for the allelic level, respectively. On the average 3.8% (0-7.7%) of the total laboratories showed unacceptable results in the crossmatch tests. CONCLUSIONS: The rates of correct antigen identification and of unacceptable crossmatch were similar to those of previous surveys, which were considered satisfactory. The Korean proficiency survey program may have contributed to a high quality of HLA tests today and should be continued for further improvements of the tests tomorrow.
Alleles ; Data Collection ; HLA Antigens/*blood/genetics ; HLA-A Antigens/blood/genetics ; HLA-B Antigens/blood/genetics ; HLA-C Antigens/blood/genetics ; HLA-DQ Antigens/blood/genetics ; HLA-DR Antigens/blood/genetics ; Haplotypes ; Histocompatibility Testing/*standards ; Humans ; Korea ; Laboratories ; Quality Control

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