肾移植中的虚拟交叉匹配,设拉子基于web程序开发的经验。

IF 0.3 Q4 TRANSPLANTATION International Journal of Organ Transplantation Medicine Pub Date : 2021-01-01
N Jamshidian Tehrani, B Geramizadeh, S A Malekhosseini, S Nikeghbalian, A Bahador, S Gholami, G A Raees Jalali, J Roozbeh, M H Anbardar, N Soleimani, N Rasaei, S Mohammadzadeh
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引用次数: 0

摘要

背景:肾移植可提高终末期肾病患者的生存和生活质量。在任何分配系统中,交叉配型试验在供体-受体配型中起着至关重要的作用。目的:在本研究中,我们旨在测试基于网络的程序的好处,该程序捕获HLA抗体分析并提供报告,以实现快速准确的虚拟交叉匹配。方法:从肾移植候诊名单中抽取100例潜在受者。纳入的患者均具有完整的HLA抗体谱。此外,还选择了10名来自既往肾脏移植(2020年)的潜在供体,这些供体具有A、B和DR位点的可用HLA分型结果。在100名受者和10名潜在供者之间进行比较,虚拟交叉匹配(VXM)由基于网络的程序和经验丰富的免疫学家手动执行。结果:人工VXM的平均时间为每位患者30分钟,而虚拟跨网络程序的平均时间为每位患者5分钟。在12%的手工VXM病例中,对数据的二次回顾改善了最终结果。在两次人工虚拟交叉配型中,VXM结果在受体抗体与供体HLA分型匹配时存在错误,这可能影响移植的最终决定。结论:总之,基于网络的评估HLA数据的VXM程序可以准确地执行VXM,减少人为错误。对于高度敏感的候选人尤其如此。
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Virtual Crossmatching in Kidney Transplantation, Shiraz Experience in Development of a Web-Based Program.

Background: Kidney transplantation can increase survival and quality of life in patients with end-stage renal disease. In any allocation system, the crossmatch test plays an essential role in donor-recipient compatibility.

Objective: In this study, we aim to test the benefits of a web-based program that captures HLA antibody analyses and provides a report to allow fast and accurate virtual crossmatches.

Methods: One hundred potential recipients in the waiting list of renal transplants were selected. The included patients all had a complete HLA antibody profile. Also, 10 potential donors from previous kidney transplants (2020), with available HLA typing results for A, B, and DR locus, were also selected. A comparison was made between 100 recipients against ten potential donors, and virtual crossmatching (VXM) was performed by the web-based program and manually by an experienced immunologist.

Results: The average time for a manual VXM was 30 minutes per patient, while the virtual cross web-based program took 5 minutes per patient. In 12% of the manual VXM cases, a secondary review of data improved final results. In two manual virtual crossmatches, the VXM results had errors in matching recipient antibodies with the donor HLA typing that could affect the final decision for transplantation.

Conclusion: In conclusion, a web-based VXM program that assesses HLA data can accurately perform a VXM with fewer human errors. It is especially true for highly sensitized candidates.

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来源期刊
CiteScore
1.60
自引率
0.00%
发文量
0
审稿时长
12 weeks
期刊介绍: The International Journal of Organ Transplantation Medicine (IJOTM) is a quarterly peer-reviewed English-language journal that publishes high-quality basic sciences and clinical research on transplantation. The scope of the journal includes organ and tissue donation, procurement and preservation; surgical techniques, innovations, and novelties in all aspects of transplantation; genomics and immunobiology; immunosuppressive drugs and pharmacology relevant to transplantation; graft survival and prevention of graft dysfunction and failure; clinical trials and population analyses in the field of transplantation; transplant complications; cell and tissue transplantation; infection; post-transplant malignancies; sociological and ethical issues and xenotransplantation.
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