Aim: In some cases, getting enough cells from a deceased donor to perform crossmatches and DNA extraction for HLA typing is challenging. Specifically this is observed more often in the case for pediatric donors and trauma donors who have received several transfusions and are hemodiluted. We explored the possibility of using buccal swabs as a source of DNA in order to save the live lymphocytes for crossmatches.

Method: Blood and buccal swab samples from 24 deceased organ donors (4 pediatrics, age 3 months to 17 years and mean age 141.5 months), and 20 adults) were processed in parallel using two different Qiagen DNA extraction kits, one specific for buccal swabs and another for blood. DNA concentration, quality, and HLA type from blood and buccal swab were compared. Linkage real time-PCR kits and Suretyper software were used to obtain the HLA types (A, B, C, DRB1, DQB1; some samples were also typed in DQA1, DPA1 and DPB1).

Results: 24 (100%) and 21 (87.5%) of the DNA obtained from blood and buccal swabs, respectively, had a concentration greater of 20ug/ml. From the DNA extracted from buccal swabs, 23/24 of the samples matched the type obtained by blood. Only one sample mismatched on the DQA1 locus, and that was an adult buccal swab sample which had a DNA concentration below 20ug/ml. Importantly, all pediatric buccal swab samples had a DNA concentration over 50ug/ml and matched the HLA type obtained by DNA from blood. The high quality of the samples was demonstrated by the ability to obtain a HLA type.

Conclusion: Buccal swab is an acceptable source for donor's DNA and it is an efficient way to save cells for crossmatches. This is especially important on donors that are hemodiluted or for pediatric donors, from which usually we receive a limited amount of blood. In conclusion, we would recommend that further cases are collected for comparison however, buccal swabs may be a good source of DNA for both deceased adult and pediatric organ donors HLA typing.

CITATION INFORMATION: Muse C, Longobardi S, Gimferrer I, Orlowski J. Using Buccal Swabs for Deceased Organ Donor HLA Typing. Am J Transplant. 2017;17 (suppl 3).

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