HLA typing, transplants and Oragene (part 2)

The Genetic Link welcomes guest blog authors. This guest submission is from Michael D. Gautreaux, Ph.D., an Associate Professor in the Department of General Surgery at Wake Forest University School of Medicine. He is currently the director of the HLA/Immunogenetics Laboratory at Wake Forest University/Baptist Medical Center. This is Dr. Gautreaux's second in a series of articles on HLA typing with the Oragene self-collection kit. We welcome Dr. Gautreaux back as a guest author and we hope you enjoy the second article in this series.

As I mentioned in the first article I wrote a few weeks ago, I work in an HLA (human leukocyte antigen) laboratory. In the first article, I talked about what HLA typing is and how it works for transplantation (particularly for leukemia patients). I promised to follow-up with details on how Oragene fits in the HLA typing market.

So how does Oragene fit in?  The samples we usually receive for HLA typing are blood drawn from a patient. Remember my question at the beginning of the first article -- "Do you like getting stuck by a needle when you give a sample of blood?". Few people do. We have successfully used the Oragene kit to get sufficient DNA to do HLA typings. It is important to us to have sufficient DNA of high quality so that our testing results are accurate. I was willing to put my mouth where my money is, in a semi-literal sense. We utilized saliva specimens from my children, some of the lab staff’s children and most of my laboratory’s staff -- including me. I didn’t even cry once!

We validated the Oragene kits with our current testing methodologies. The picture below is an actual SSP typing from DNA isolated from my daughter’s saliva.

As a result of the validation study, we drew a couple of conclusions. 

1. First, the DNA collected from saliva with Oragene is a good source of cells as long as the proper preparation is done. This is clearly outlined in the user instructions that accompany the kit. 
2. Second, one tube is sufficient for a complete high-resolution typing by SSP for a healthy donor. However, 2 or 3 tubes might be required from a leukemia patient with low white blood cell counts. The nice thing about Oragene is that even if multiple samples are required from the leukemia patient, it does not require multiple venipunctures. 
3. Thirdly, this method appears to work well even if a patient’s leukocyte count is very low. 
4. Lastly, the kit is not perfect but nothing in laboratory medicine is. However, the Oragene kit does offer significant advantages such as eliminating the need for a blood draw.

Overall, I am very impressed with this system and will recommend it whenever appropriate.

If you would like to learn more about Oragene and how it can work for HLA typing, click here to read a case study about how the Anthony Nolan Trust in the UK switched from blood to Oragene.