Profile of a Pathology Faculty Member

Pathology Faculty Photo

Robert A Bray, PhD

HLA and Transplantation

Pathology & Laboratory Medicine

Other Appointments/Positions

Winship Cancer Center, The Emory Clinic

Co-Director, Histocompatibility & Molecular Immunogetics Laboratory, Emory University Hospital

Pathology Division(s):
Clinical Pathology

Email Address:


B.S.   (Microbiology), Indiana University, Bloomington, IN, - 1977
Ph.D.   (Immunology), Indiana University School of Medicine, Indianapolis, IN, - 1985

Research Interests:

- Overview - The thrust of my research has been almost exclusively applied. Since my training and clinical responsibilities encompass two quite distinct entities, my research has also moved in several directions. However, an underlying theme has been the application of "State-of-the-Art" technology, specifically Flow Cytometry, to advances in diagnostic testing. In the area of transplantation, my projects have focused on the flow cytometric crossmatch and flow cytometric detection of alloantibody in patients awaiting transplantation. Our research efforts have essentially helped "set the standard of practice" for flow cytometric crossmatching and antibody identification in the United States. Additionally, we were one of the first laboratories to pioneer the area of microbead technology and its applications in clinical histocompatibility testing. Work that has been published from this laboratory has not only changed laboratory practice, but has been the foundation for changes in government (CLIA) and society (ASHI and UNOS) standards which regulate histocompatibility testing laboratories. In the area of clinical diagnostic flow cytometry, we have focused on cutting-edge applied projects. Our work has been primarily aimed at the utility of cytometry in the detection and classification of hematopoietic disease. To this end, our laboratory has been one of the leaders in flow cytometric analysis, an interpretation of leukemia/ lymphoma immunophenotyping. Of special interest have been our efforts at detecting minimal/residual hematopoietic disease. As a result of our efforts, we have also been able to help set the "standard of practice" in diagnostic flow cytometry. Our work contributed to a "consensus" document which has laid the foundation for standardized data analysis and interpretation in diagnostic cytometry (Borowitz M, Bray RA, Gascone R, etal: Cytometry 30:236-244, 1997). In summary, although almost exclusively "applied and translational" in nature, our projects have had a significant impact on the practice of laboratory medicine and patient care. This has not only benefited patients here at Emory, but through the field of Transplantation and Hematopathology. As a result, Emory has gained a reputation for excellence in these areas. This is evidenced by numerous requests from outside laboratories and Pathologists, desiring to learn our methods and to visit our laboratory for specific training.

Clinical Focus:

I co-direct, along with Dr. Howard Gebel, the busy HLA laboratory at Emory University Hospital, which provides histocompatibility testing to support transplantation services at Emory Healthcare and beyond.

Specialty Boards:

  • Diplomate - American Board of Histocompatibility & Immunogenetics (ABHI)
  • ABB - Certified American Board of Bioanalysis, High Complexity Clinical Laboratory Director (HCLD),

Selected/Most Recent Publications:

Click here to view all publications

Published and Accepted Research Articles -

  • Bray RA, Hurley CK, Kamani NR, Woolfrey A, M¿ller C, Spellman S, Setterholm M, Confer DL. National Marrow Donor Program HLA Matching Guidelines for Unrelated Adult Donor Hematopoietic Cell Transplants. Biology of Blood and Marrow Transplantation. Vol. 14, (9):45-53, 2008.
  • Saw CL, Bray RA, Gebel HM. Cytotoxicity and antibody binding by flow cytometry: A single assay to simultaneously assess two parameters. Clinical Cytometry 74B:287-294, 2008.
  • Spellman S, Setterholm M, Maiers M, Noreen H, Oudshoorn M, Fernandez-Vi¿a M , Petersdorf E, Bray R, Hartzman R, Ng J, Hurley CK. Advances in the Selection of HLA- Compatible Donors: Refinements in HLA Typing and Matching over the First 20 Years of the National Marrow Donor Program Registry. Biology of Blood and Marrow Transplantation Vol. 14 (9): 37-44, 2008.
  • Kamani N, Spellman S, Hurley CK, Barker JN, Smith FO, Oudshoorn M, Bray RA, Smith AJ, Williams T, Logan B, Eapen M, Anasetti C, Setterholm M, Confer DL. State of the Art Review: HLA Matching and Outcome of Unrelated Donor Umbilical Cord Blood Transplants. Biology of Blood and Marrow Transplantation Vol. 14(1):1-6), 2008.
  • Gebel HM and Bray RA.. Laboratory Assessment of HLA antibodies circa 2006. Making Sense of Sensitivity. Transplantation Reviews 20:189-194, 2006.
  • Adamkiewicz TV. Boyer MW. Bray RA. Haight A. Yeager AM. Identification of unrelated cord blood units for hematopoietic stem cell transplantation in children with sickle cell disease. Journal of Pediatric Hematology/Oncology. 28(1):29-32, 2006.
  • Bray RA, JD L Nolen, C Larsen, T Pearson, KA Newell , K Kokko , A Guasch , P Tso, J.B. Mendel and HM Gebel. Transplanting the Highly Sensitized Patient: The Emory Algorithm. Am. J. Transplantation (6):2307-2315, 2006.
  • Young HE. Duplaa C. Romero-Ramos M. Chesselet MF. Vourc'h P. Yost MJ. Ericson K. Terracio L. Asahara T. Masuda H. Tamura-Ninomiya S. Detmer K. Bray RA. Steele TA. Hixson D. el-Kalay M. Tobin BW. Russ RD. Horst MN. Floyd JA. Henson NL. Hawkins KC. Groom J. Parikh A. Blake L. Bland LJ. Thompson AJ. Kirincich A. Moreau C. Hudson J. Bowyer FP 3rd. Lin TJ. Black AC Jr. Adult reserve stem cells and their potential for tissue engineering. Cell Biochemistry & Biophysics. 40(1):1-80, 2004.
  • Gloor JM, DeGoey S, Ploeger N, Gebel HM, Bray RA, Moore SB, Dean PG, and Stegall MD. Persistence of Low Levels of Alloantibody after Desensitization in Crossmatch Positive Living Donor Kidney Transplantation. Transplantation 78(2):221-7, 2004 .
  • Bray RA, Nickerson P, Kerman R and Gebel, HM. Evolution of HLA antibody Detection: Technology Emulating Biology. Immunologic Research, 29:41-53. 2004.
  • Bray RA, Harris, SB, Josephson CD, Hillyer CD, and Gebel HM. Unappreciated risk factors for transplant patients: HLA antibodies in blood components. Hu. Immunol. 65, 240-244, 2004.
  • Bearden CM. Agarwal A. Book BK. Sidner RA. Gebel HM. Bray RA. Pescovitz MD. Pronase treatment facilitates alloantibody flow cytometric and cytotoxic crossmatching in the presence of rituximab. Human Immunology. 65(8):803-9, 2004.
  • Gebel HM, Bray RA and Nickerson P. Pre-transplant Assessment of Donor Reactive HLA Specific Antibodies in Renal Transplantation: Contraindication vs Risk. Am. J. Transplantation 3:1488-1500, 2003.
  • Pearson TC. Trambley J. Odom K. Anderson DC. Cowan S. Bray RA. Lin A. Hollenbaugh D. Aruffo A. Siadak AW. Strobert E. Hennigar R. Larsen CP. Anti-CD40 therapy extends renal allograft survival in rhesus macaques. Transplantation. 74(7):933-40, 2002.
  • Gebel HM. Harris SB. Zibari G. Bray RA. Conundrums with FlowPRA beads. Clinical Transplantation. 16 Suppl 7:24-9, 2002.

Book Chapters -

  • Gebel HM,, Pollack MS and Bray RA. The HLA system. In; AABB Technical Manual, 16th Edition. Roback J, Combs M, Grossman B and Hillyer C, eds. Chapter 19, pps. 547-568; 2008.
  • Saw CL, Heaney DL, Gebel HM and Bray RA. Relevance of antibody screening in solid organ, hematopoietic stem cell transplantation and blood transfusion. In; Handbook of Human Immunology; 2nd Edition. O'Gorman M and Donnenberg A, eds: Chapter19; pps. 565-588; 2008.
  • Bray RA and Gebel HM. 2007. Clinical utility of flow cytometry in allogeneic transplantation. Ch. 14. pp.275-292. In: Clinical Flow Cytometry. ASCP Press, Chicago, IL., (Keren, D., ed.)..
  • Bray RA, Gebel HM, Ellis TM. Flow Cytometric Assessment of HLA Alloantibodies. In: Current protocols in Cytometry. John Wiley & Sons, Inc. (Robinson JP, ed.). Supplement 27, Chapter 6.16, pp.1-23, 2004.
  • Bray RA. Flow Cytometry in Histocompatibility Testing. In. Seminars in Hematology. Academic Press, New York, N.Y. (Fleisher T. ed.). Vol. 38;194-200, 2001.
  • Bray RA and Gebel HM. Clinical utility of flow cytometry in allogeneic transplantation. In: Clinical Flow Cytometry. ASCP Press, Chicago, IL., (Keren, D., ed.). pp. 505-534, 2001.
  • Bray, RA and Gebel, HM. Transplantation Immunophenotyping. In. Immunophenotyping: Cytometric and Cellular Analysis. Academic Press, NY. (Stewart and Nicholson, J. eds.) . pp.321- 332, 2000.
  • Bray, RA Flow Cytometric Crossmatching in Solid Organ Transplantation. In: Methods in Cell Biology: Flow Cytometry, Vol. 41, (Darzynkiewicz, Z, Crissman, H.Z, and Robinson, J.P., eds). Chapter 7, pp103-119, 1994.
  • Landay AL, George SK, Bray RA. Phenotyping Cells of the Immune System: Methods and Applications. In: Techniques in Diagnostic Pathology, No. 2, Diagnostic Flow Cytometry; JS Coon and RS Weinstein, eds. Williams & Wilkins, Inc. pp. 55-77, 1991.
  • Gebel HM and Bray RA. Transplant Applications of Flow Cytometry. In: Techniques in Diagnostic Pathology, No. 2, Diagnostic Flow Cytometry; JS Coon and RS Weinstein, eds. Williams & Wilkins, Inc. pp. 79-88, 1991.
  • Landay AL and Bray RA. Flow Cytometry of Urine. In: Clinics in Laboratory Medicine, Vol. 8., No. 3, pp.541-555, 1988.

Other Publications -

  • Bray, RA and Stempora LL. Phenotyping by Immunofluorescence. In: ASHI Laboratory Manual. American Society for Histocompatibility and Immunogenetics, 1994.
  • Bray RA and Gebel HM. Principles of Isolation and Separation of Human Mononuclear Cells. In: ASHI Laboratory Manual. American Society for Histocompatibility and Immunogenetics, 1994.
  • Leffell MS and Bray RA. Principles of Immunofluorescence and Flow Cytometry. In: ASHI Laboratory Manual. American Society for Histocompatibility and Immunogenetics, 1994.
  • Bray RA and Gebel HM. Principles of Isolation and Separation of Human Mononuclear Cells. In: ASHI Laboratory Manual. American Society for Histocompatibility and Immunogenetics, 1990.