Laboratory support for transplantation.

Abstract

The clinical laboratory plays a major role in support of transplantation. Depending on the spectrum and number of transplants performed, such programs can consume up to 35% of all laboratory testing. This testing can be transplantation-nonspecific or -specific. The former constitutes routine laboratory procedures in various areas of laboratory medicine that are common to other categories of patients. Transplantation-specific testing includes tissue typing, procedures for assessment of graft viability/rejection, and measurement of immunosuppressive drugs. Because of the development of new immunosuppressive drugs such as FK506, cyclosporin G, and rapamycin, an increased burden will be placed on laboratories to establish new therapeutic monitoring programs. Preliminary guidelines for monitoring these drugs, similar to those previously established for cyclosporin A, are proposed herein. With the use of an increasing spectrum of immunosuppressive drug combinations, and the possible use of xenotransplantation on the horizon, new demands will be placed on the laboratory for the support of transplant programs.