A glance on Immunogenetics Laboratory: from the origins to the future

Abstract

Histocompatibility and Immunogenetics (H&I) laboratories have currently a significant relevance in clinical and research medical fields. The purpose of this review is to investigate their role through an excursus between bioethics, histocompatibility history and laboratory organization. The histocompatibility laboratories play an essential role in the transplantation process, and, through their molecular techniques, they can affect clinical decisions in a remarkable way. Half a century has passed from the first paper, published in 1958, to the modern deep sequencing techniques; in these years through specific guidelines and international standards drafted by 2 specific bodies (ASHI and EFI), H&I laboratories are subjected to continuous controls by inspection authorities formed by professionals in the Immunogenetics field. For their functioning, H&I laboratories require: a structure and devices, a dedicated room and a clear path to samples workflow. In these laboratories, the personnel must be specialized even just in a single precise assignment, and every member is assigned to a role according to the experience matured over the years. In these laboratories, the role of Director/Co-Director or Technical Supervisor is usually assigned to a staff member with a minimum of 4 years of experience in Immunogenetics or transplantation fields, following the EFI/ASHI Standards. Bioethics is another important aspect because, in the last few years, there has been a major change in legal regulations on informed consent. The advent of digitization has pushed many laws on personal and genetic data treatment to be adapted to most modern guidelines, although they may differ according to the countries in Europe and USA. In the last years, the H&I laboratories turned as great resources with many clinical features and nowadays they may lead an important transformation in research and clinical fields.