肾移植中的虚拟交叉配型：设拉子在基于网络程序开发方面的经验
Virtual Crossmatching in Kidney Transplantation, Shiraz Experience in Development of a Web-Based Program.
作者信息
Jamshidian Tehrani N, Geramizadeh B, Malekhosseini S A, Nikeghbalian S, Bahador A, Gholami S, Raees Jalali G A, Roozbeh J, Anbardar M H, Soleimani N, Rasaei N, Mohammadzadeh S
机构信息
Shiraz Transplant Center, Abu-Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Shiraz Nephro-Urology research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
出版信息
Int J Organ Transplant Med. 2021;12(2):20-25.
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.
背景
肾移植可提高终末期肾病患者的生存率和生活质量。在任何分配系统中，交叉配型试验在供受者相容性方面都起着至关重要的作用。
目的
在本研究中，我们旨在测试一个基于网络的程序的益处，该程序可获取HLA抗体分析结果并提供一份报告，以实现快速准确的虚拟交叉配型。
方法
选择了100名肾移植等待名单上的潜在受者。纳入的患者均有完整的HLA抗体谱。此外，还选择了10名来自既往肾移植（2020年）的潜在供者，其A、B和DR位点有可用的HLA分型结果。将100名受者与10名潜在供者进行比较，通过基于网络的程序进行虚拟交叉配型（VXM），并由经验丰富的免疫学家手动进行。
结果
手动VXM的平均时间为每位患者30分钟，而基于网络的虚拟交叉程序每位患者只需5分钟。在12%的手动VXM病例中，对数据进行二次审查可改善最终结果。在两次手动虚拟交叉配型中，VXM结果在将受者抗体与供者HLA分型匹配时出现错误，这可能会影响移植的最终决策。
结论
总之，一个评估HLA数据的基于网络的VXM程序可以准确地进行VXM，且人为错误更少。对于高度致敏的候选者尤其如此。
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