Transplantation Immunology

The Transplantation Immunology Division (TID) at Hoxworth Blood Center is a state of the art histocompatibility and immunogenetics testing laboratory that supports busy clinical transplant programs and transplantation research activities.

TID provides testing and consultation support services for both solid-organ (kidney, liver, pancreas, heart) and hematopoietic stem cell transplant programs located throughout the Greater Cincinnati area. This includes the solid organ transplant programs at The University Hospital, The Christ Hospital and Cincinnati Children's Hospital Medical Center (CCHMC), as well as two hematopoietic stem cell transplant programs at CCHMC and The Jewish Hospital. Both CCHMC and The Jewish Hospital combined are responsible for more than 100 allogeneic stem cell transplants yearly. This level of overall activity places the Hoxworth TID laboratory in the top 25 percent of all HLA laboratories in terms of testing volumes.

TID delivers state-of-the-art testing in histocompatibility and immunogenetics to assist area physicians and hospitals with immune monitoring, clinical trials and disease diagnosis to a large group of patients. The Hoxworth TID is accredited by the American Society of Histocompatibility and Immunogenetics (ASHI), HHS under the Clinical Laboratory Improvement Act (CLIA) and works within the context of the blood center's compliance with current good manufacturing practices (cGMP) concurrent with working in an FDA-regulated environment.

Laboratory Services

Immunogenetics and histocompatibility testing

The TID uses DNA-based molecular diagnostic techniques to identify HLA genes at low/intermediate or high-level allele resolution. HLA-A, -B, -C, -DR, -DQ and -DP locus types at an intermediate level of resolution are provided by reverse SSO (Sequence-Specific Oligonucleotides) hybridization.

Furthermore, PCR-SSP (Polymerase Chain Reaction-Sequence-Specific Primers) is used either for rapid (3-4 hours) determination of HLA-A, -B, -C, -DR and DQ typing at low resolution or to provide higher resolution testing.

Sequence-based typing (microcapillary sequencer) allows the highest resolution typing for HLA-A, -B, -C, -DR, -DQ (alpha and beta) and -DP alleles. In addition to HLA alleles, TID provides typing for other human histocompatibility antigens (MICA = MHC class I chain-related gene A; KIR = Killer Cell Ig-Like Receptors).

Test Turnaround Times:

Turnaround Times
Disease Association 5
HLA Class I, Molecular (low resolution) 7
HLA Class I, Molecular (high resolution) 10
HLA Class II, Molecular (low resolution) 7
HLA Class II, Molecular (high resolution) 10
Platelet Antibody 5

Detection and analysis of anti-HLA and non-HLA specific antibodies

Detection and analysis of antibody is achieved by a combination of tests including lymphocytotoxicity, ELISA (Enzyme-Linked Immunosorbent Assay), multiplex bead array (Luminex) and flowcytometry. Single-antigen testing is routinely used for antibody presence and specificity, while phenotypic tests support antibody level/titer/strength evaluations.

Test Turnaround Times:

Turnaround Times
Crossmatch - Donor, Cytotoxic 5
Crossmatch - Auto, Cytotoxic 5
Crossmatch - Donor Flow Cytometry 5
Platelet Antibody 5
PRA, Cytotoxic 5
PRA, Flow Cytometry 5
HLA Antibody Specificity (Single Antigen)
Class I / Class II

Immune monitoring for transplantation candidates and patients

TID performs a wide range of testing services including living and deceased donor workups, HLA typing by serological and/or molecular methodologies, cross matching (cytotoxic and flow), antibody analyses (cytotoxic, solid phase, and flow), virtual crossmatching, immune phenotyping, etc.

Furthermore, TID provides testing for high-volume unrelated and related blood and marrow HSC transplantation, testing for disease association, transfusion support, immune monitoring for drug therapy and clinical trials and biological specimen storage (DNA and cryopreservation of mononuclear cells).

Education and Training

  • ABHI-Sponsored Continuing Education Program Histocompatibility
  • Technologist Training Program
  • Resident and Post-Graduate Training

Research Activities

The TID is involved in a number of research activities regarding the alloimmune response in solid-organ transplantation; detection, specificity analysis of pre-formed and post-transplant developed anti- HLA alloantibodies; dynamics of post-transplant humoral immune response; outcome association (acute and chronic rejection, allograft dysfunction); markers of antibody-mediated rejection (C4d); influence of various therapeutic protocols on antibody dynamics, etc.

Selected publications

1. Reducing de novo donor-specific antibody levels during acute rejection diminishes renal allograft loss. Everly MJ, Everly JJ, Arend LJ, Brailey P, Susskind B, Govil A, Rike A, Roy-Chaudhury P, Mogilishetty G, Alloway RR, Tevar A, Woodle ES. Am J Transplant. 2009 May;9(5):1063-71.

2. Emerging role of donor-specific anti-human leukocyte antigen antibody determination for clinical management after solid organ transplantation. Zeevi A, Lunz JG 3rd, Shapiro R, Randhawa P, Mazariegos G, Webber S, Girnita A. Hum Immunol. 2009 Aug;70(8):645-50.

Useful Forms

HLA Requisition Form
TID Requisition Form
Bone Marrow Transplant Requisition Form

Laboratory Hours

8 a.m. - 5 p.m., Monday - Friday (Second shift: 4:30 p.m. - 12 a.m. Sunday - Thursday).

On-Call service is available 24/7 during non-staffed hours (weekdays, holidays and weekends) to provide laboratory-testing services.

For pricing or other information, please contact us at:

TID Laboratory Office Phone: (513) 558-1500
TID Laboratory Phone: (513) 558-1574
TID On-Call Phone: (513) 249-7725
TID Fax Number: (513) 558-1522

Assistant Director, TID: Paul A. Brailey, PhD
Phone: (513) 558-1505

Director, TID: Dr. David Wald, MD, PhD, D(ABHI)
Phone: (216) 410-9016

*Based on data from OPTN - Organ Procurement and Transplantation Network and SRTR - Scientific Registry of Transplant Recipients.