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UAB Histocompatibility Lab: Meet the Team

UAB’s Histocompatibility and Immunogenetics Lab, the only one in Alabama, is among the largest and most respected of 200 similar laboratories in the United States. The lab performs high-complexity tests to determine compatibility with prospective solid organ and bone marrow transplant recipients at UAB, Children’s of Alabama, and the Birmingham VA Medical Center. Prior to transplant, highly trained technologists perform risk assessments for patients and donors to minimize the risk of rejection, and they monitor recipients for rejection after transplant.

It is crucial work, done around the clock 365 days a year and almost always in demanding, time-sensitive circumstances. No transplant can be performed until the lab team identifies both the donor’s and the potential recipient’s histocompatibility antigens, known as human leukocyte antigens (HLAs), and then checks for predetermined anti-HLA antibodies.

A person’s HLA type is sometimes described as a barcode on the immune system’s cells. It allows the body to determine “self” from “non-self” in order to attack invading organisms. That is what determines rejection. Nearly half of patients are found to be incompatible with their intended living donors.

The technologists work behind the scenes in a maze-like area of offices and closed lab spaces, so patients do not have contact with this group (except for the patient coordinator) that plays such a vital role in the process of successful organ transplantation. In order to provide more background about the team’s work and their experiences, we asked everyone in the lab to answer some questions below.

Name: Angela Hutchens
Title: Histocompatibility Technologist, Lead
Education: BS in clinical laboratory science; certified medical technologist from the American Society of Clinical Pathology (ASCP); certified Histocompatibility Specialist (CHS) from the American Board of Histocompatibility and Immunogenetics (ABHI)

What are your specific tasks in the lab?
I am a lead technologist, and my focus is quality control.

When did you know you wanted to have a career in medicine? Was there an event or experience that prompted your interest?
My father is a physician, and back when HIPAA was not a thing, I would go to the hospital with him on weekends to see patients and sit at the nurses’ station. Medicine has always fascinated me, but I knew that being a doctor was not for me. When I would go to his office, the lab was where I hung out and felt the most at home.

What do you see as special or unique about the lab and/or your colleagues?
I have worked in a general laboratory (hematology, chemistry, urinalysis) setting full and part time since 2001, but what sets the HLA lab apart is that you know you are directly affecting another person’s quality of life. That is what keeps me here. I have to use more of my brain, not just my hands.

What has been most rewarding about your experience at UAB?
One day in particular has stood out for the last seven years. It was my first weekend to be back on call since maternity leave with my third baby, and it just happened to be Mother’s Day. I came in to do the workup between a pediatric heart import (non-Alabama) donor and a child who had been living at Children’s of Alabama in need of a new heart (one of them had the same name as one of my children). All I could think of during my work was how much it meant to the one mom/family for their child to be getting a brand new start and then for the other mom/family to be going through the heartache of loss and still be able to give someone else hope.

Name: Clorissa Briseno
Title: Histocompatibility Technologist
Education: MS, MLS (ASCP), Certified Histocompatibility Technologist (ABHI)

What are your specific tasks in the lab?
I run pre- and post-transplant antibody tests on all of our patients, do investigative work and additional testing on special case patients, perform molecular-based HLA typing on new donors and patients, and run any STAT work necessary for transplant through the nights and weekends.

When did you know you wanted to have a career in medicine?
My MS degree led me into the medical side of my interests, even though I had always seen myself in a research lab setting instead of a hospital. Having experienced a job on both sides, I enjoy the rewards of working in a hospital, where I see a more direct impact on people’s lives through the work I do. I can “see” all the work coming together from start to finish, from patients being evaluated for transplant to reporting the final crossmatch, which results in them getting the organ they need.

What do you see as special or unique about the lab and/or your colleagues?
Our job requires a lot of flexibility throughout the shift. Donor work comes up unannounced and at any given time. You start out doing one test or task, but sometimes that ends up getting switched three to four times within the day to prioritize an urgent need that comes up. We all adapt so well and figure out a new game plan as things change. We take over for someone else so they can start in on donor work, we run multiple time-consuming tasks, and really do anything needed to get our test results in good time for people who are waiting on those results to get a transplant.

What has been most rewarding about your experience at UAB?
I love how many altruistic donors and living donors (friends and relatives) we get for our patients. I have met a few recipients of (living-donor) kidneys, and they seem like the happiest people. They know they have another shot at life because someone donated a kidney. It is so rewarding to be a small part of something so amazing.

Tell us a few personal details about yourself.
I love to bake and cook. My husband and I enjoy riding the mountainous terrain in Alabama on our horses, Belle and Boogie. Our newest adventure is starting to learn mounted archery and mounted shooting with our horses. My favorite vacation place is my home state, Michigan.

Name: Crystal Bynum
Title: Histocompatibility Technologist
Education: Bachelor of Science, Certified Histocompatibility Technologist (ABHI)

What are your specific tasks in the lab?
I perform DNA extractions and molecular-level assays for bone marrow transplant recipients and donors.

When did you know you wanted to have a career in medicine? Was there an event or experience that prompted your interest?
I have known since I was about six or seven years of age that I wanted a career in medicine. I took health-related studies in high school, and that passion continued throughout college. I believe my sister’s experience in the hospital made the greatest impact on me. She had to have hip surgery in high school. Seeing how much care she received inspired me to research a medical career that would resonate most with me.

What do you see as special or unique about the lab and/or your colleagues?
What’s special about this laboratory is the collaboration among the director, managers, and technologists. We really work together to make the workload manageable. We are truly a team.

What has been most rewarding about your experience at UAB?
Since I have worked for UAB more than 10 years and also graduated college from here, I have had many rewarding experiences. If I had to choose one, I would say it is hearing the testimony of a colleague who donated a kidney to a patient. Hearing how the experience impacted his life was truly heartwarming and inspiring. That colleague no longer works here, but his impact lingers on.

Tell us a few personal details about yourself.
I have a sewing hobby. I love to travel and try different restaurants and food pairings. I really like to play and/or watch most sports. Basically, I am willing to try anything that looks fun.

Name: Leta Gulley
Title: Histocompatibility Technologist
Education: BS; Certified Histocompatibility Technologist (ABHI)

What are your specific tasks in the lab?
As an on-call technologist, I perform highly complex tests on clinical specimens for organ transplant and antibody assigning, which are necessary to determine the compatibility of recipients and donors. I create detailed reports summarizing data collected in the laboratory for heart, lung, and kidney transplantation. I rotate on-call schedules, on the weekend, as well as weekly and holiday rotation.

When did you know you wanted to have a career in medicine? Was there an event or experience that prompted your interest?
As a child, I would always watch my grandmother, who retired from UAB as an ER nurse, get ready for work. She took much pride in what she did, from ironing her uniform to being on time to work every night. Seeing how dedicated she was, I knew I wanted to follow in her footsteps and join the medical field.

What do you see as special or unique about the lab and/or your colleagues?
This lab is very unique because we aim to give patients/recipients a second chance at life.

What has been most rewarding about your experience at UAB?
The most rewarding experience has been working here in the same department for 18 years. Just as my grandmother’s career did, that shows dedication and the love I have for my job and my colleagues.

Tell us a few personal details about yourself.
I have three kids: a junior in college (20), a senior in high school (17), and a freshman in high school (14). I started working here when my oldest was only two years of age. I’m proud of them all, and they keep me busy!

Name: Michael “Mike” Riley
Title: Clinical Lab Manager
Education: BA, Certified Histocompatibility Specialist (ABHI)

What are your specific tasks in the lab?
As the clinical lab manager, I’m responsible for the day-to-day operations of the lab along with three directors, an administrative manager, and six supervisors. Part of those operations include facilitating the directors, staffing, training, competency, annual review, and engaging with the staff on what we do and why we do it. I have other duties and assignments as needed to support the transplant team.

When did you know you wanted to have a career in medicine? Was there an event or experience that prompted your interest?
As far back as I can remember, I wanted a career in the medical field. My dream was to become a pediatrician. After three and a half years in college, I enlisted in the U.S. Air Force to further my education. I signed up for the USAF Medical Laboratory Specialist program. After completing my laboratory practicum at Sheppard AFB in Texas, I was reassigned to USAF Wilford Hall Medical Center in San Antonio. While working one evening in the lab, I saw a supervisor delivering samples to the main lab in a red and white Igloo cooler with “HLA Lab” written on it. I asked him what the HLA Lab was, and he invited me to stop by. After our conversation there I asked him if I could come in during the day shift (I worked evening shift) and learn how to “tissue type.” After some time learning the techniques, I was asked if I might be interested in a position in the lab to replace a tech who was leaving the service. I said yes! That was 40 years ago. So a red and white Igloo cooler with “HLA Lab” written on it piqued my curiosity and ignited my career.

What do you see as special or unique about the lab and/or your colleagues?
Both the lab and my colleagues are special as well as unique. The HLA Lab at UAB is the only one of its kind in Alabama. All of the training is done on the job because of how specialized we are. “Unique” is how we describe the HLA technologists who work here. At a moment’s notice, the HLA on-call techs have come in to do testing, 24/7, 365. This type of response can be very stressful on one’s lifestyle as well as emotional state. Over the years I’ve noticed that those who experience this type of job either love it or hate it. It’s hard to imagine how someone would love such a demanding job, but that’s where our humanity kicks in. We provide some of the necessary testing that aids in decisions that provide someone the gift of life.

What has been most rewarding about your experience at UAB?
What’s most rewarding has been the opportunity to work with the transplant team to make a difference in the lives of our patients who are waiting for lifesaving organs.

Tell us a few personal details about yourself.
My favorite pastime is doing home improvement projects for myself and others. Being that I was born in the city of jazz, jazz is the music of choice for me. I played jazz several years during junior high up to my college days. Now, I sit back and listen. I am a chef by trade, so I love to cook. I also enjoy most sports and sporting events. I’ve travelled to 37 of the 50 states. The other 13 states are on my bucket list of things to do.

Name: Alexander Johnson
Title: Histocompatibility Technologist
Education: Mississippi State University, Bachelor of Science in medical technology; Vanderbilt University Medical Center, graduate certificate in medical laboratory science (MLS); American Society of Clinical Pathology, board-certified medical laboratory scientist

What are your specific tasks in the lab?
I am a technologist in the solid organ side of the lab. We are responsible for performing high-complexity testing such as flow crossmatches to determine compatibility between donor and recipient; single-antigen solid-phase bead assays to monitor pre- and post-transplant antibody profiles; and DNA typing by polymerase chain reaction (PCR) to provide donor and recipient molecular genetic profiles. I also participate in the on-call rotation for deceased donors.

When did you know you wanted to have a career in medicine? Was there an event or experience that prompted your interest?
My desire to be a part of the medical field began when I was very young, watching my mother excel in the field of nursing and my father as a chemical engineer. This developed into a passion for science.

What do you see as special or unique about the lab and/or your colleagues?
Our lab is special because of the complexity of the work we do. Also, I believe it is unique that almost everyone comes from different educational backgrounds, but all have the same goal of providing excellent care for the patients and the families we serve. Our lab is crucial to the transplant program.

What has been most rewarding about your experience at UAB?
Reading all of the success stories from patients and their families and how they are so grateful to have a second chance at life. It is the most rewarding feeling to know that even though we don’t see the patients, we make a huge difference in their lives.

Tell us a few personal details about yourself.
In my spare time, I enjoy woodworking and learning about small-engine mechanics. I also enjoy landscaping and recently started composting to reduce waste and my impact on the environment. I love spending time with my wife, who is also named Alex (we are Alex2), and my two dachshunds, Marty and Cali, our fur babies.

Name: Stephanie Langner
Title: Histocompatibility Technologist, Lead
Education: BS in laboratory science from Auburn University; clinical internship at St. Vincent’s Hospital in Jacksonville, Fla., Certified Histocompatibility Specialist (ABHI)

What are your specific tasks in the lab?
Training technologists and performing and reviewing laboratory testing for solid organ transplants

When did you know you wanted to have a career in medicine? Was there an event or experience that prompted your interest?
I originally wanted to have a career in science, not medicine. I started out taking the chemistry track in college, quickly realized that was not what interested me, began a pre-med track, changed my mind again, and finally found my way to clinical laboratory science. It included everything that I liked about my chemistry and pre-med classes.

What do you see as special or unique about the lab and/or your colleagues?
When a patient is called to UAB, Children’s, or the VA for a deceased-donor transplant, we get called in to do all the testing for the case. Most of the time it is in the middle of the night. Every case is treated as an emergency and taken very seriously.

What has been most rewarding about your experience at UAB?
Working here has challenged me to further my understanding and knowledge in this field. We are the only transplant lab in Alabama, so I know I can’t get this experience anywhere else in the state. I’ve learned a lot, and it has allowed me to pass the Histocompatibility Specialist exam.

Tell us a few personal details about yourself.
I’m married to my college sweetheart, and we have two young children and a chocolate Labrador Retriever. I love summertime, the beach, and being outside.

Name: Vicki Cline
Title: Administrative Support Specialist
Education: High school

What are your specific tasks in the lab?
My main, most important and most rewarding responsibility is the Kidney Paired Donation Program/Kidney Chain. I call patients and donors to coordinate sample draws for crossmatching. I communicate with transplant doctors, coordinators, and lead technicians on the progress of those arrangements and receipt of the kits. Second would be policies and procedures. Updating any formatting changes that are needed and getting them uploaded to Compliance 360. There are numerous other administrative responsibilities that keep me busy.

When did you know you wanted to have a career in medicine? Was there an event or experience that prompted your interest?
Being a secretary, I didn’t really choose medicine, although several of my jobs over the years have been in doctors’ offices. When I applied for this particular position, I had no idea what this department was about. When HR explained, it just seemed very interesting. Once I got here, I fell in love with my job and the opportunity to make a difference in people’s lives.

What do you see as special or unique about the lab and/or your colleagues?
No matter the differences there may be among my co-workers, we all have in common the desire to help people whom we will probably never meet.

What has been most rewarding about your experience at UAB?
Working with the Kidney Paired Donation Program, I talk with several patients and donors to coordinate sample draws for preliminary and final crossmatches. I can’t describe the feeling I get when I see them get scheduled for transplant.

Tell us a few personal details about yourself.
I love listening to Christian music and attending church at Gardendale First Baptist. I love the beach. I love going to Bradenton, Fla., whenever I get a chance, to visit with my brother. I love spending time with my family and playing card games. I have two sons and one granddaughter. I talk too much for there to be something people don’t know about me.

Name: Stephen Skelton
Title: Histocompatibility Technologist, Lead
Education: BS, Certified Histocompatibility Specialist (ABHI)
What are your specific tasks in the lab?
Antibody analysis, troubleshooting, filling in, and doing whatever needs to be done

What do you see as special or unique about the lab and/or your colleagues?
To work here you have to have a unique skill set that is specific for transplantation medicine. You have to realize that we are part of a big picture that has the ultimate goal of better health and quality of life for the patients. We are one of the few areas that serve patients when they are a pre-transplant patient, at the time of transplant, and then after the transplant.

What has been most rewarding about your experience at UAB?
Knowing that you make a difference