CPT® Code 86822

Deleted

1. Indications

HLA typing using primed lymphocyte culture (PLC) is indicated for several specific clinical scenarios, including:

• Transplant Compatibility Determining the compatibility of a potential stem cell, bone marrow, or solid organ transplant donor with the intended recipient.
• Susceptibility to Disease Identifying individuals who may have a genetic predisposition to certain diseases based on their HLA alleles.

2. Procedure

The procedure for HLA typing using primed lymphocyte culture (PLC) involves several detailed steps:

• Step 1: Preparation of Cells The process begins with the collection of lymphocytes from the individual being tested. These cells are then mixed with primed lymphocyte typing (PLT) reagents, which serve as the responder cells in the culture.
• Step 2: Culture Setup The PLT responder cells are placed on microtiter plates alongside the stimulator cells, which are the cells to be tested for HLA compatibility. This setup allows for the interaction between the responder and stimulator cells.
• Step 3: Incubation After the cells are mixed on the microtiter plates, the plates are sealed to maintain a controlled environment and incubated for a period of 48 hours. This incubation allows the cells to interact and respond to each other.
• Step 4: Thymidine Addition Following the initial incubation, thymidine is added to the cultures. This compound is crucial for measuring cell proliferation, as it is incorporated into the DNA of dividing cells.
• Step 5: Final Incubation The plates are incubated for an additional 16 hours after the addition of thymidine. This extended incubation period allows for further cellular activity and proliferation.
• Step 6: Harvesting Cultures Once the incubation period is complete, the cultures are harvested. The harvested cells are dried on glass fiber filter paper, which prepares them for subsequent analysis.
• Step 7: Scintillation Counting After drying, each filter spot is placed in a separate tube containing scintillation fluid. These tubes are then analyzed using a scintillation counter, which measures the radioactivity of the samples to determine the results of the HLA typing.

3. Post-Procedure

After the HLA typing procedure is completed, the results are interpreted to assess compatibility between the donor and recipient. The interpretation of the PLT results is critical for making informed decisions regarding transplant eligibility and potential outcomes. There are no specific post-procedure care requirements mentioned; however, it is essential for healthcare providers to communicate the results to the involved parties and discuss any further steps or considerations based on the findings.