NHSBT provides blood and transplant services in the UK. The Histocompatibility and Immunogenetics (H&I) department conducts serology and molecular testing, including investigating antibody compatibility for transplants via wet or virtual crossmatching in serology. Molecular testing focuses on Next Generation Sequencing to match transplant recipients and donors, and monitors patients after transplants using chimerism testing. Working in the H&I laboratory provided opportunities to gain laboratory skills, complete an IBMS portfolio, and obtain knowledge applicable to a career in laboratory science.

1. HISTOCOMPATIBILITY AND IMMUNOGENETICS
BARNSLEY NHSBT
Lois Glazier

2. NHSBT is the NHS blood and transplant service. This includes providing the blood
donation service to England and transplant services to the UK.
NHSBT core values: Caring, Expert, Quality
NHSBT core purpose: to save and improve lives

3. H&I
H&I is split into serology and molecular laboratories.
Serology
Investigates antibodies. Can do wet or virtual crossmatch to
check compatibility of antibodies for transplants.
Molecular
Performs three main tests: NGS, chimerism, B27s. Looks at
the HLA.

4. B27S
 Used to aid diagnosis for SpA/AS.
 Manual technique for extracting DNA and sequencing using gel electrophoresis.

5. B27 ANALYSIS

6. NEXT GENERATION SEQUENCING
 Used to match patient and donor for renal
transplants and HSCT.
 Looks at alleles for coeliac disease, birdshot
retinopathy, narcolepsy, Behcet's disease
and abicavir sensitivity.
 The process takes four days: booking the
sample in, DNA extraction, setting up,
running on the MiSeq.

7. CHIMERISM
 Monitors the patient after an allo-HSCT.
 Checks that the patient isn't relapsing, is accepting the graft, and isn't having an
adverse reaction such as GVHD.
 Can be done for patients with a single donor, or patients with multiple cord donors.

8. SKILLS AND EXPERIENCE GAINED
 Laboratory skills: pipetting, weighing, using equipment such as centrifuges,
nanodrop, flow cytometer, thermocyclers, genetic analysers, MiSeq.
 Opportunity and support to complete IBMS portfolio.
 Transferrable skills: teamwork, time management, responsibility, problem
solving, attention to detail, independence, reliability, working under pressure.
 Knowledge: H&I theory, PITS course, opportunity to visit other departments,
attend journal club.

9. CONCLUSION
 Working in a H&I laboratory allowed me to gain laboratory skills and become
trained in tests such as NGS and chimerism which is useful for a career in a lab.
 I got opportunities to attend talks and courses to gain more knowledge on my
placement subject area.
 I was supported to do my IBMS portfolio which allows me to go straight into
laboratory work after completing my degree.
 I gained transferrable skills which will help me in the future in any career that I go
into.