Alzahrani M, Qahtani Z, Harbi H, Kebasi S, Essa O, Al Attas R
Histocompatibility and Immunogenetic Laboratory, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia.
Histocompatibility and Immunogenetic Laboratory, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia.
Transplant Proc. 2019 Mar;51(2):488-491. doi: 10.1016/j.transproceed.2019.01.005. Epub 2019 Jan 4.
Results of 773 actual flow crossmatches (aFXMs) and virtual flow crossmatches (vFXMs) performed for living and deceased donor kidney transplantation in our center were analyzed retrospectively and evaluated for their concordance. Prediction of vFXMs was based on antibody identification using single antigen bead assay and locally established mean fluorescence intensity cutoff point compared with donor HLA antigens. The vast majority of aFXMs were in concordance with vFXMs with an overall concordance of 97%. Twenty-three predicted to be negative showed positive aFXMs; 12 of them had 0% calculated panel-reactive antibody, and 11 were found in patients with multiple non-donor-specific HLA antibodies. Three predicted positive vFXMs yielded negative aFXMs; 2 of them had allele-specific antibodies. CONCLUSIONS: vFXMs based on precise characterization of antibody specificities detected by single antigen bead assay using our cutoff point accurately predicted FXMs in the majority of patients and can be used safely to allocate kidney offers without performing physical crossmatches in selected patients.
对本中心进行的773次活体和尸体供肾移植实际流式交叉配型（aFXM）及虚拟流式交叉配型（vFXM）结果进行回顾性分析，并评估其一致性。vFXM的预测基于使用单抗原珠分析法进行的抗体鉴定以及与供体HLA抗原相比本地确定的平均荧光强度截断点。绝大多数aFXM与vFXM一致，总体一致性为97%。23次预测为阴性的结果显示aFXM为阳性；其中12次计算的群体反应性抗体为0%，11次出现在具有多种非供体特异性HLA抗体的患者中。3次预测为阳性的vFXM产生了阴性aFXM；其中2次具有等位基因特异性抗体。结论：基于使用我们的截断点通过单抗原珠分析法精确鉴定抗体特异性的vFXM在大多数患者中准确预测了FXM，并且可以安全地用于在选定患者中分配肾脏供体，而无需进行实际交叉配型。
