评估HLA配型匹配度作为移植物存活和抗HLA抗体存在情况的预测指标。

Evaluation of HLA Matchmaker compatibility as predictor of graft survival and presence of Anti-HLA antibodies.

作者信息

Silva E, Alba A, Castro A, Carrascal M, Buckel E, Aguiló J, Herzog C, Calabrán L, Morales J, Fierro J A

机构信息

Centro Clínico epidemiológico, Hospital Clínico de la Universidad de Chile.

出版信息

Transplant Proc. 2010 Jan-Feb;42(1):266-9. doi: 10.1016/j.transproceed.2009.12.047.

DOI:10.1016/j.transproceed.2009.12.047

PMID:20172326

Abstract

BACKGROUND

HLA Matchmaker is a computer algorithm developed to evaluate donor/receptor compatibility comparing sequences of polymorphic aminoacids (eplets) present in human leukocyte antigen (HLA) molecules. The aim of this study was to evaluate the predictive value of HLA Matchmaker for patient and graft survival, graft survival free of rejection, and the presence of anti HLA antibodies.

METHODS

Using this program, 62 of 173 kidney transplant patients, were retrospectively analyzed. HLA-I loci eplet mismatch value (EMM) was determined and correlated with graft survival, graft survival free of rejection, and the presence of anti HLA-I antibodies. EMM was compared with the traditional HLA antigen mismatch value (MM) in terms of the presence of anti HLA-I antibodies.

RESULTS

Graft survival and graft survival free of rejection showed no statistical differences (P-value .975 and .365, respectively) while comparing patients with less or more than 10 HLA-I EMM. Patients with > or =6 HLA-B EMM had an odds ratio (OR) of 5.6 (95% confidence interval [CI], 0.47-66.45) of presenting anti HLA-I antibodies, with a sensitivity of 80% and specificity of 58.3%. For > or =2 HLA-B MM, the OR was 2.58 (95% CI, 0.46-14.5), with a sensitivity of 40% and specificity of 75%.

CONCLUSION

Even though in our study population compatibility by HLA Matchmaker did not correlate with graft survival or rejection-free graft survival, it showed a better sensitivity than traditional HLA antigen matching for the presence of anti HLA-I antibodies. HLA Matchmaker is a promising tool in predicting the appearance of anti-HLA antibodies.

摘要

背景

HLA匹配器是一种计算机算法，用于通过比较人类白细胞抗原（HLA）分子中多态性氨基酸（表位）的序列来评估供体/受体的相容性。本研究的目的是评估HLA匹配器对患者和移植物存活、无排斥反应的移植物存活以及抗HLA抗体存在情况的预测价值。

方法

使用该程序对173例肾移植患者中的62例进行回顾性分析。确定HLA - I位点表位错配值（EMM），并将其与移植物存活、无排斥反应的移植物存活以及抗HLA - I抗体的存在情况进行关联分析。就抗HLA - I抗体的存在情况而言，将EMM与传统的HLA抗原错配值（MM）进行比较。

结果

在比较HLA - I EMM小于或大于10的患者时，移植物存活和无排斥反应的移植物存活均无统计学差异（P值分别为0.975和0.365）。HLA - B EMM≥6的患者出现抗HLA - I抗体的优势比（OR）为5.6（95%置信区间[CI]，0.47 - 66.45），敏感性为80%，特异性为58.3%。对于HLA - B MM≥2，OR为2.58（95% CI，0.46 - 14.5），敏感性为40%，特异性为75%。