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The history and evolution of HLA typing external proficiency testing schemes in UK NEQAS for H&I

The UK National External Quality Assessment Service (NEQAS) provide an external proficiency testing (EPT) service for clinical laboratories. UK NEQAS for Histocompatibility and Immunogenetics (H&I) has been providing EPT schemes for over 45 years and has grown during this time to provide 19 EPT...

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Autores principales: De’Ath, A., Rees, M. T., Pritchard, D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544324/
https://www.ncbi.nlm.nih.gov/pubmed/37790700
http://dx.doi.org/10.3389/fgene.2023.1272618
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author De’Ath, A.
Rees, M. T.
Pritchard, D.
author_facet De’Ath, A.
Rees, M. T.
Pritchard, D.
author_sort De’Ath, A.
collection PubMed
description The UK National External Quality Assessment Service (NEQAS) provide an external proficiency testing (EPT) service for clinical laboratories. UK NEQAS for Histocompatibility and Immunogenetics (H&I) has been providing EPT schemes for over 45 years and has grown during this time to provide 19 EPT schemes. Accurate human leucocyte antigen (HLA) typing is critical to support safe clinical services, including transplantation, therefore high quality, relevant EPT schemes are required as part of a laboratory’s quality assurance. This article reviews the development of the HLA typing EPT schemes, from the first HLA phenotyping scheme in 1975, via the first HLA genotyping scheme in 1992, through to the introduction in 2017 of HLA third field assessment results from next-generation sequencing technology. In addition, the introduction of EPT schemes to cover HLA associated diseases and pharmacogenetic reactions, including HLA-B27, HLA*B*57:01 and HLA-DQ for coeliac disease are discussed. The accuracy of laboratory EPT results for HLA phenotyping are >96% (2018–2022), HLA genotyping >99% (2020–2022), HLA-B27 testing >99% (2018–2022) and B*57:01 testing >99% (2017–2022). However, for HLA genotyping for coeliac disease 22%–46% of laboratories made errors in 2020–2022. On investigation, the high rate of unsatisfactory performance was attributed to laboratories lacking specific knowledge to interpret HLA genotyping results and accurately report HLA types for coeliac disease. A misleading commercial kit insert was also identified. The assessment of scheme results has uncovered several issues which have been addressed with the intention of educating participants and improving clinical services. The UK NEQAS for H&I EPT schemes have evolved over the past four decades to reflect changes in HLA typing technology, laboratory clinical practice and to cover post-analytical interpretative elements of HLA typing.
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spelling pubmed-105443242023-10-03 The history and evolution of HLA typing external proficiency testing schemes in UK NEQAS for H&I De’Ath, A. Rees, M. T. Pritchard, D. Front Genet Genetics The UK National External Quality Assessment Service (NEQAS) provide an external proficiency testing (EPT) service for clinical laboratories. UK NEQAS for Histocompatibility and Immunogenetics (H&I) has been providing EPT schemes for over 45 years and has grown during this time to provide 19 EPT schemes. Accurate human leucocyte antigen (HLA) typing is critical to support safe clinical services, including transplantation, therefore high quality, relevant EPT schemes are required as part of a laboratory’s quality assurance. This article reviews the development of the HLA typing EPT schemes, from the first HLA phenotyping scheme in 1975, via the first HLA genotyping scheme in 1992, through to the introduction in 2017 of HLA third field assessment results from next-generation sequencing technology. In addition, the introduction of EPT schemes to cover HLA associated diseases and pharmacogenetic reactions, including HLA-B27, HLA*B*57:01 and HLA-DQ for coeliac disease are discussed. The accuracy of laboratory EPT results for HLA phenotyping are >96% (2018–2022), HLA genotyping >99% (2020–2022), HLA-B27 testing >99% (2018–2022) and B*57:01 testing >99% (2017–2022). However, for HLA genotyping for coeliac disease 22%–46% of laboratories made errors in 2020–2022. On investigation, the high rate of unsatisfactory performance was attributed to laboratories lacking specific knowledge to interpret HLA genotyping results and accurately report HLA types for coeliac disease. A misleading commercial kit insert was also identified. The assessment of scheme results has uncovered several issues which have been addressed with the intention of educating participants and improving clinical services. The UK NEQAS for H&I EPT schemes have evolved over the past four decades to reflect changes in HLA typing technology, laboratory clinical practice and to cover post-analytical interpretative elements of HLA typing. Frontiers Media S.A. 2023-09-18 /pmc/articles/PMC10544324/ /pubmed/37790700 http://dx.doi.org/10.3389/fgene.2023.1272618 Text en Copyright © 2023 De’Ath, Rees and Pritchard. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Genetics
De’Ath, A.
Rees, M. T.
Pritchard, D.
The history and evolution of HLA typing external proficiency testing schemes in UK NEQAS for H&I
title The history and evolution of HLA typing external proficiency testing schemes in UK NEQAS for H&I
title_full The history and evolution of HLA typing external proficiency testing schemes in UK NEQAS for H&I
title_fullStr The history and evolution of HLA typing external proficiency testing schemes in UK NEQAS for H&I
title_full_unstemmed The history and evolution of HLA typing external proficiency testing schemes in UK NEQAS for H&I
title_short The history and evolution of HLA typing external proficiency testing schemes in UK NEQAS for H&I
title_sort history and evolution of hla typing external proficiency testing schemes in uk neqas for h&i
topic Genetics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544324/
https://www.ncbi.nlm.nih.gov/pubmed/37790700
http://dx.doi.org/10.3389/fgene.2023.1272618
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