Introduction: Our Tissue Typing and Transplantation Laboratory (Adana Hospital) was accredited by the European Federation of Immunogenetics (EFI) in 2013 and has been working with the most advanced technological equipment and trained personnel in accordance with the accreditation rules since then. Pre-transplantation immunological evaluation of the recipient is performed before transplantation. Patient and donor selection are determined by studies conducted according to the accreditation rules of the tissue typing and transplantation laboratory.
Method: HLA typing is performed by low-resolution LUMNEX method and high-resolution SBT and NGS methods. Cross match studies are performed serologically by complement-based cytotoxicity method and simultaneously by flow cytometry method. PRA screening, identification and LSA tests are performed to determine the recipient's existing anti-HLA antibodies. In post-transplant follow-up, the development of Denova antibodies is performed by LSA follow-up (MFI >1000 are considered positive) (Fig 1, 2). CD3+ T cells and their subgroups, and CD19+B cells ratios are monitored by immunophenotyping in order to evaluate the treatment-related immune system. Serum and DNA samples of patients are archived and stored. Immunological follow-up of patients are performed in tissue typing and transplantation laboratories in accordance with the Başkent University algorithm The transplantation immunologist provides consultative support in patient follow-up and evaluation of treatment before and after transplantation.
Results: HLA typing (50.607), Flow cross-match (1760) , CDC-cross match (1876) PRA screening and identification (16.872) LSA (396 )has been studied in the Transplantation Immunology laboratory since its establishment. With these studies 154 patients for transplantation successfully underwent heart, hematopoietic stem cell transplantation (Otolog (736), allogeneic (499), haploidentic (80), unrelated (73) total 1388), renal transplantation and liver transplantation.
A total of (Kidney transplantation 3539, liver 760, cornea 390 ) successful transplants were performed in four different transplantation centers. 
Conclusion: Our primary goal is to ensure the recipient’s tolerance to the graft tissue as a result of sensitive studies and evaluations. The rate of graft failure is approximately 20%, for kidney transplants and 5%f for heart transplants. Our Transplantation center, in addition to routine pre-transplant follow-up studies, consultation, training and research studies are also carried out in the molecular immunology laboratory.