Histocompatibility (SLS134)

10 credits

Aim of this module

This module will provide the trainee with knowledge and understanding of the causes of immunodeficiency. They will understand the clinical presentation and investigation of a range of immunodeficient conditions and the principles and practice of immunotherapy. They will become familiar with methods and strategies to investigate immunodeficiency and gain experience of the interpretation of patient results in a variety of clinical settings.

This module will provide the trainee with the practical application of knowledge and skills relating to the scientific and practical basis of Histocompatibility.

  1. Select and perform laboratory tests for Human Leukocyte Antigen (HLA) antibody identification, definition and data analysis.
  2. Select and perform laboratory tests required for the clinical work up of patients awaiting solid organ transplantation, including cross matching for solid organ transplantation.
  3. Perform the clinical and laboratory work up of patients referred for investigation of platelet refractoriness.
  4. Work in partnership with other clinical specialisms in the investigation of patients referred for transplantation, platelet transfusion, and where appropriate, with other service users and support staff.
  5. Apply specific accreditation standards governing the use of serological practices.
Number Work-based learning outcome Title Knowledge
1 1, 2, 3

Receive samples for patients undergoing transplant workup or investigation of platelet refractoriness and enter onto Laboratory Information Management System (LIMS).

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2 1, 2, 3

Isolate serum/plasma from blood samples according to local protocol.

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3 2

Isolate and quantify lymphocytes from anti-coagulated blood according to local protocol.

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4 2

Isolate and quantify lymphocytes from deceased potential donor spleen and lymph node according to local protocol.

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5 2

Perform the cryopreservation of lymphocytes from different sources

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6 1, 2, 3,5

Perform laboratory methods for HLA antibody detection for example:

  • Complement dependent cytotoxicity
  • ELISA
  • Flow cytometry
  • X-MAP Technologies(Luminex)
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7 1, 2, 3,5

Perform laboratory methods for HLA antibody definition, including: 

  • Complement dependent cytotoxicity
  • ELISA
  • Flow cytometry
  • xMAP Technologies(Luminex)
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8 2,5

Select appropriate sera for the cross-matching of donor and recipients in accordance with local and national guidelines.

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9 2,5

Perform according to local protocol, laboratory methods for crossmatching donors and recipients for solid organ transplantation by the following methods as appropriate

  • Complement dependent cytotoxicity
  • Flow cytometry
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10 3,5

Perform laboratory testing for a patient referred for investigation of platelet refractoriness, including:

  • HLA typing
  • Antibody testing
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11 4

Work in partnership with other clinical specialisms in the investigation of patients referred for transplantation, platelet transfusion and where appropriate, with service users and support staff.

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12 4

Communicate effectively with the healthcare team, recognising and responding appropriately to situations where it is necessary to share information to safeguard service users or the wider public.

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You must complete
2 Case-based discussion(s)
2 of the following DOPS / OCEs
Assessment Title Type
Prepare blood samples for HLA antibody detection and identification DOPS
Prepare blood samples for donor recipient crossmatching DOPS
Perform the cryopreservation of lymphocytes from patient and or donor samples DOPS
Perform tests to detect HLA specific antibodies DOPS
Undertake a test for the definition of HLA specific antibodies DOPS
Prepare an interpretive HLA antibody profile report DOPS
Perform testing for HPA antibodies DOPS
Prepare an interpretive patient antibody profile report DOPS
Take a patient history OCE
Explain procedure and the risks and benefits of the investigation to obtain written and informed consent OCE
Attend a multidisciplinary review meeting at which laboratory results are presented - Prepare a case study, including learning points and clinical outcomes. OCE

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning Outcomes

  1. Discuss the clinical implications of immunodeficiency and the primary and secondary causes of immunodeficiency.
  2. Explain the role of the humoral and cellular components of the immune system in immunodeficiency.
  3. Describe the design, operation and performance of laboratory tests and assays used to investigate and define immunodeficiency.
  4. Explain the principles of immunotherapy.
  5. Describe and monitor the impact of immunotherapeutic treatments.
  6. Discuss and justify appropriate immunotherapeutic strategies/treatment regimens for patients with a range of primary and secondary immunodeficiencies.
  7. Describe the partnership between the clinical immunology laboratory and other clinical specialisms in the investigation of immunodeficiency and immunotherapy and patient care.

Indicative Content

  • Assessing immune function (T lymphocytes; B lymphocytes; phagocytes; complement)
  • Deficiencies of innate immunity (phagocytic cell defects; leukocyte adhesion defects; complement system defects)
  • B lymphocyte deficiencies (X-linked agammaglobulinaemias; selective IgA deficiency; IgG subclass deficiency; common variable immunodeficiency; transient hypogammaglobulinaemia of infancy; selective specific antibody deficiencies)
  • T lymphocyte deficiencies (Di George syndrome; Ommen’s syndrome; bare lymphocyte syndrome; X-linked hyper IgM syndrome; severe T cell deficiencies [X-linked recessive form; adenosine deaminase (ADA) deficiency; purine nucleoside phosphorylase (PNP) deficiency])
  • Combined T and B cell defects
    • Severe combined immunodeficiency (SCID) (autosomal recessive SCID; T cell receptor immunodeficiency; MHC Class II deficiency; IL-2 production defect)
    • Wiskott-Aldrich syndrome
  • Secondary immunodeficiencies (iatrogenic; neoplasia; infection)
  • Cytokine defects
  • Human immunodeficiency virus (HIV) and AIDS
    • Pathogenesis of HIV infection
    • Epidemiology, prevalence and modes of transmission
    • Laboratory abnormalities in HIV infection
    • Management of HIV infection (drug therapies; vaccines)
  • Immunotherapy
    • Antibodies as immunosuppressive agents (plasmapheresis and plasma exchange; monoclonal antibody therapy; generation of antibodies; ‘magic bullet’ therapy)
    • Immunosuppressive drugs (corticosteroids; cyclosporin and tacrolimus; other anti-inflammatory agents)
    • Other immunosuppressive agents (X-irradiation; ultraviolet light)
    • Cytokines and anti-cytokines (interleukin-1; interleukin-2; interferons; tumour necrosis factors [TNF]; Th1/Th2 balance)
    • Immune modulation by intravenous immunoglobulins
    • Immune potentiation (hormones; cytokine therapy; gene therapy)
    • Other uses of monoclonal antibodies
    • Stress and the immune system (psycho-neuro-endocrino-immune pathway)
    • Immunisation against infection (adjuvants; routine immunisations; travel immunisations; passive immunisation; new vaccines)
    • Cancer immunotherapy
    • Novel approaches to autoimmune disease (T cell vaccines; oral tolerance)
    • Other approaches (lymphocyte vaccination; blocking T cell-adenomatous polyposis coli [APC] interactions; gene repair; patient specific amplification of cytotoxic cells; stem cell therapies)