Authors: Nóra Nagy, Efi Melista, Krisztina Rigó, Peter Meintjes, Tim Hague
Abstract:
Recent technological advances in sequencing and related library preparation methods, cumulatively called Next Generation Sequencing (NGS) have provided new opportunities that allow the complete characterisation of the HLA genes in haploid fashion and are beginning to make their way to HLA laboratories for genotyping purposes. For many clinical labs the scientific benefit of generating whole gene consensus sequences, the >3 field resolution of the typing method and the ability to batch very large numbers of samples may not be sufficiently compelling to make the decision to switch to NGS. However, for small and large labs, the economics of adopting NGS are undeniably favorable in the long run after a moderate investment in capital equipment.
This work outlines the relative costs associated with implementing HLA typing using NGS on whole gene consensus sequences, and compares them to conventional molecular methods SBT and SSO.
At large volumes and for 11 loci, NGS is also cost competitive with SSO, so this technology can support both solid organ (SOT) and bone marrow (BMT) workflows. Finally, with high resolution typings for all HLA loci, including DRB3/4/5 – against which antibodies may be formed post-transplant – the reflexive determinations of these types during post-transplant monitoring will not be required, further reducing overall cost of treatment.
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