HLA‐AB typing by polymerase‐chain reaction with sequence‐specific primers: more accurate, less errors, and increased resolution compared to serological typing

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Abstract
Until recently, serological typing has been the primary technique used for HLA class I analysis. But because of limitations, molecular‐typing techniques have replaced or supplemented the microlymphocytotoxicity test. It has been assumed that HLA class I serological typing was more accurate than serological HLA‐DR typing; the latter has been shown to have 10–25% errors. But several studies have shown that HLA‐AB typing was poorer than expected, and error frequencies between 5–25% were reported. This study systematically investigated the accuracy of HLA class I serological AB typing in healthy, bone‐marrow registry donors, necrokidney donors, kidney‐transplantation patients (on waiting lists), and haematological disorder patients. Genomic HLA class I typing, which uses polymerase‐chain reaction with sequence‐specific primers (PCR‐SSP), gave discrepant results in 3–24% of the patients, compared to serological typings. The highest error rate (24%) was found among haematological disorder patients. Among the kidney waiting‐list patients and necrokidney donors, 11% discrepancies were found. In the consecutively typed bone‐marrow donors group, 3% errors were found. But among those with only one detected HLA‐A specificity, 12% discrepancies were found, and among donors with only one detected HLA‐B specificity, 19% errors were found. Based on these results, we recommend that patients with haematological disorders should be typed using genomic techniques. In investigations of bone‐marrow registry donors and kidney patients, in which only one serological specificity is found, additional typing by genomic methods should be done1.