Tissue Typing Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
H&I Laboratory, NHSBT Birmingham Vincent Drive, Birmingham, UK.
Int J Immunogenet. 2022 Feb;49(1):22-29. doi: 10.1111/iji.12558. Epub 2021 Sep 23.
All UK H&I laboratories and transplant units operate under a single national kidney offering policy, but there have been variations in approach regarding when to undertake the pre-transplant crossmatch test. In order to minimize cold ischaemia times for deceased donor kidney transplantation we sought to find ways to be able to report a crossmatch result as early as possible in the donation process. A panel of experts in transplant surgery, nephrology, specialist nursing in organ donation and H&I (all relevant UK laboratories represented) assessed evidence and opinion concerning five factors that relate to the effectiveness of the crossmatch process, as follows: when the result should be ready for reporting; what level of donor HLA typing is needed; crossmatch sample type and availability; fairness and equity; risks and patient safety. Guidelines aimed at improving practice based on these issues are presented, and we expect that following these will allow H&I laboratories to contribute to reducing CIT in deceased donor kidney transplantation.
英国所有的 H&I 实验室和移植单位都在单一的国家肾脏供体政策下运作，但在何时进行移植前交叉配型试验方面，方法存在差异。为了将供体肾移植的冷缺血时间降至最低，我们试图寻找尽早报告交叉配型结果的方法。一个由移植外科、肾脏病学、器官捐献专科护理和 H&I（所有相关的英国实验室都有代表）方面的专家小组评估了与交叉配型过程有效性相关的五个因素的证据和意见，如下所示：结果应准备好报告的时间；需要何种水平的供体 HLA 分型；交叉配型样本类型和可用性；公平性和公正性；风险和患者安全。提出了旨在基于这些问题改进实践的指南，我们期望遵循这些指南将使 H&I 实验室能够为减少供体肾移植的冷缺血时间做出贡献。
