United Kingdom National External Quality Assessment Service

1

• United Kingdom National External Quality
  Assessment Service
• " helping to ensure clinical laboratory test
  results are accurate, reliable and comparable
  wherever they are produced
• Histocompatibility Immunogenetics
• Educational Scheme 2007

2
for HI - Educational
Scheme

• Scheme 1A HLA Phenotyping
• Scheme 4A DNA HLA Typing
• Both use random blood donor samples largely
  north-western European Caucasoids
• Educational Scheme uses selected donors of
  particular interest from serological and/or
  DNA-based typing
• Acquired from WBMDR donor panel of some 62,000
  donors

3
for HI -
Educational Scheme

• Gratis
• Have to participate in Schemes 1A and/or 4A
• 2 send-outs per year of 2 samples each
• Area of interest and best method(s) to
• employ are indicated
• Report within 7 weeks
• No scoring or assessment

4
for HI -
Educational Scheme

• ALLELES/SPECIFICITIES OF INTEREST - 2008
• ED01/08 - B1511 - B75
• - B3904 - B39
• ED02/08 - A2417 - short A24
• - B1502 - B75
• ED03/08 - A0224 - A2
• ED04/08 - DRB11320 - DR13

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for HI Educational
Scheme 2006
ED01/08 HLA allele / specificity of interest
B1511 - B75, B3904 - B39 16 serology reports
44 of labs assigned B75, 37 B15 and 13 B62
(1 lab - B35!) 93 assigned B39 - remainder
B16 30 DNA-based findings 63 assigned
B1511/151101 17 B1511 with 1 or 2 other
alleles 20 assigned B15 63 assigned B3904
20 B3904 with 1 or 2 other alleles 17 B39
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for HI Educational
Scheme 2006

• ED02/08 A2417 - short A24, B1502 - B75

17 serology reports 53 of labs assigned A24
29 A9 18 (3) missed A24/A9 59 assigned B75
35 B15 1 lab missed B75/B15 30 DNA-based
findings 43 assigned A2417 (2 with 1 other
allele) 47 A24 2 labs A2402 and 1 lab A24
null 63 assigned B1502 (9 with B9512, 2 with
2 other alleles) 33 B15 1 lab missed B15
7
for HI Educational
Scheme 2006

• ED03/08 A0224 - A2

A0224 differs from A0201 by a single base (C/A)
at 453 substitution corresponds to site of a
primer for A02-amplifying SSP mixes A2 detected
by serology but missed by SSP Freq - 1 in
4,000 Random example in 2001 - Scheme 1A -
17/18 labs found A2 by serology but 7/24 (29)
missed A022 by SSP ED03/08 18 serology
reports All labs assigned A2 31 DNA-based
findings 55 assigned A0224 (1 with 1 other
allele) 39 A02 1 A0201 1 lab missed A02
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for HI Educational
Scheme 2006

• ED04/08 - DRB11320 - DR13
• 16 serology reports but only 9 reported class II
  serology
• 6 labs assigned DRB113 1 DRB111/13 2 labs
  missed DRB113
• 33 DNA-based findings
• 67 assigned DRB11320 (2 with 1 or 2 other
  alleles) 21 DRB113 1 each of sample mix-up,
  DRB113/14, DRB11301, missed DRB113

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for HI - Educational
Scheme

• PARTICIPANTS COMMENTS
• FORMAT
• Number and frequency of samples
• Information provided with samples
• Format of labs findings
• Information provided with results
• IS THE EDUCATIONAL SCHEME
• Educational ?
• Worthwhile ?

10
for HI -
Educational Scheme

• SUGGESTIONS FOR FURTHER EDUCATIONAL SAMPLES
• Expression variants
• Rare alleles
• Unusual 2-locus associations
• Serologically difficult specificities
• DO WE NEED THE SEROLOGY COMPONENT ?
• IS TESTING RARE ALLELES BY DNA-BASED METHODS A
  WASTE OF TIME ?
• SHOULD WE BE TESTING INTERESTING ANTISERA, e.g.
  BY LUMINEX ?