hla-typebestemmelse (LH Indholdsside)

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      <HtmlField Name="PageContent"><![CDATA[<h2>Definition<a href=" " data-type="journal-reference" data-value="Mamode N, Bestard O, Claas F, Furian L, Griffin S, Legendre C, Pengel L, Naesens M, European Guideline for the Management of Kidney Transplant Patients With HLA Antibodies: By the European Society for Organ Transplantation Working Group. Transpl Int 2022;35: 10511" data-value-piped="Mamode N, Bestard O, Claas F, Furian L, Griffin S, Legendre C, Pengel L, Naesens M|European Guideline for the Management of Kidney Transplant Patients With HLA Antibodies: By the European Society for Organ Transplantation Working Group.|Transpl Int|2022|35|10511|36033645" data-url="reference-link" data-pubmedid="36033645" title="Mamode N, Bestard O, Claas F, Furian L, Griffin S, Legendre C, Pengel L, Naesens M, European Guideline for the Management of Kidney Transplant Patients With HLA Antibodies: By the European Society for Organ Transplantation Working Group. Transpl Int 2022;35: 10511"><sup>1</sup></a>,&nbsp;<sub><sup><a href=" " data-type="journal-reference" data-value="Naito T, Okada Y, HLA imputation and its application to genetic and molecular fine-mapping of the MHC region in autoimmune diseases. Semin Immunopathol 2022;44: 15-28" data-value-piped="Naito T, Okada Y|HLA imputation and its application to genetic and molecular fine-mapping of the MHC region in autoimmune diseases.|Semin Immunopathol|2022|44|15-28|34786601" data-url="reference-link" data-pubmedid="34786601" title="Naito T, Okada Y, HLA imputation and its application to genetic and molecular fine-mapping of the MHC region in autoimmune diseases. Semin Immunopathol 2022;44: 15-28"><sup>2</sup></a>,&nbsp;<a href=" " data-type="journal-reference" data-value="Hurley CK, Naming HLA diversity: A review of HLA nomenclature. Hum Immunol 2021;82: 457-465" data-value-piped="Hurley CK|Naming HLA diversity: A review of HLA nomenclature.|Hum Immunol|2021|82|457-465|32307125" data-url="reference-link" data-pubmedid="32307125" title="Hurley CK, Naming HLA diversity: A review of HLA nomenclature. Hum Immunol 2021;82: 457-465"><sup>3</sup></a></sup></sub><sup></sup></h2>
<ul>
    <li>Humant leukocyt antigen = HLA </li>
    <li>De vigtigste humane v&aelig;vsforligeligheds-antigener tilh&oslash;rer HLA-systemet </li>
    <li>De er til stede p&aring; alle kerneholdige celler og trombocytter og p&aring;vises let p&aring; lymfocytter. HLA molekyler er meget immunogene
    <ul>
        <li>Patientens HLA-type bestemmes ved gentypebestemmelse eller vha. specifikke anti-HLA antistoffer</li>
    </ul>
    </li>
    <li>Det er mange forskellige varianter af HLA-molekylerne - de er meget polymorfe. Hvert individ har sin bestemte kombination af HLA-molekyler </li>
    <li>HLA-molekylerne opdeles prim&aelig;rt i klasse I og klasse II. HLA-molekylernes vigtigste funktion er at pr&aelig;sentere antigener for immunsystemets T-celler </li>
    <li>Klasse I HLA pr&aelig;senterer antigen til CD8 T celler og klasse II HLA pr&aelig;senterer antigen til CD4 T celler </li>
    <li>N&aring;r transplantation overvejes, udf&oslash;res HLA-typebestemmelse for at vurdere graden af forligelighed mellem donor og modtager. Stor grad af forligelighed reducerer risikoen for, at transplantatet afst&oslash;des </li>
    <li>HLA-typebestemmelse udf&oslash;res ogs&aring; i forbindelse med udredning af specifikke autoimmune sygdomme og ved transfusionsrefrakt&aelig;r trombocytopeni pga. HLA-antistoffer&nbsp;hos patienten</li>
</ul>
<ul>
</ul>
<h2>Aktuelle indikationer</h2>
<ul>
    <li>Bed&oslash;mme forligelighed i forbindelse med transplantation og transfusion med trombocytter</li>
    <li>Ved mistanke om autoimmun sygdom, s&aelig;rligt&nbsp;<a href="~/link.aspx?_id=2B3022F9A5604E188E7E032EDBB010FC&amp;_z=z">morbus Bechterew</a>
    <ul>
        <li>HLA-B27 findes hos 95 % af dem der lider af morbus Bechterew, men ogs&aring; hos 10 % af normalbefolkningen </li>
        <li>Frav&aelig;r af dette antigen reducerer sandsynligheden for Bechterew diagnosen </li>
    </ul>
    </li>
</ul>
<h2>Pr&oslash;vetagning</h2>
<ul>
    <li>5 ml EDTA blod</li>
</ul>
<h2>Vurdering af unormalt pr&oslash;vesvar</h2>
<ul>
    <li>Visse HLA-antigener er associeret med forskellige autoimmune sygdomme
    <ul>
        <li><a href="~/link.aspx?_id=2B3022F9A5604E188E7E032EDBB010FC&amp;_z=z">Mb Bechterew</a>: HLA-B27 </li>
        <li><a href="~/link.aspx?_id=935A845E8C8643229D937C40DCE2A30F&amp;_z=z">C&oslash;liaki</a>: HLA-DQ2 </li>
        <li><a href="~/link.aspx?_id=939AB6BE2EA74C2890648DEA4AF5E6C6&amp;_z=z">Rheumatoid arthrit</a>: HLA-DR4 </li>
    </ul>
    </li>
</ul>
<h2>Opf&oslash;lgning af unormalt pr&oslash;vesvar</h2>
<ul>
    <li>Man kan ikke basere diagnoser p&aring; resultater fra HLA-type, men positive pr&oslash;ver kan indg&aring; i kriterierne </li>
    <li>Den nyttigste information fra HLA-B27 testen er ved negativt pr&oslash;vesvar</li>
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