RESUMO
Calculated panel reactive antibody (CPRA) is used to help increase sensitized patient's access to transplantation. United Arab Emirates (UAE) has a diverse resident population hence we developed a UAE-CPRA calculator based on HLA antigen frequencies of the different ethnic groups that represent the UAE population. HLA antigen frequencies at serological split antigen level for HLA-A, -B, -C, -DRB1 and -DQB1 of 1002 healthy unrelated donors were performed. We subsequently compared the performance of the UAE CPRA calculator with the Organ Procurement and Transplantation Network (OPTN) and the Canadian CPRA calculators in 110 Kidney Transplant waitlist patients from January 2016 to December 2018. Lin's concordance correlation coefficient showed a moderate agreement between the UAE and OPTN calculator (Rc = 0.949, 95% CI 0.929-0.963) and the UAE and Canadian calculators (Rc = 0.952, 95% CI 0.932-0.965). While there continued to be a moderate agreement (Rc = 0.937, UAE versus OPTN calculator) in the lower sensitized group, a poor agreement (Rc = 0.555, UAE versus OPTN calculator) was observed in the higher sensitized group. In this study, we provide a template for countries to develop their own population-specific CPRA calculator. Implementation of the CPRA algorithm based on HLA frequencies of the multi-ethnic UAE population will be more fitting to increase access to transplantation and improve transplant outcomes. Our study demonstrates that the CPRA calculators developed using the data from the western population had poor correlation in our higher sensitized patients disadvantaging them in potential organ allocations systems. We plan to further refine this calculator by using high resolution HLA typing to address the problem of a genetically diverse population.
Assuntos
Transplante de Rim , Humanos , Estudo de Prova de Conceito , Emirados Árabes Unidos , Canadá , Anticorpos , Antígenos HLA , Teste de HistocompatibilidadeRESUMO
HLA-A*01:380:01:02 is a variant of A*01:01:01:01, differing by five nucleotide substitutions.
Assuntos
Sequenciamento de Nucleotídeos em Larga Escala , Mutação de Sentido Incorreto , Alelos , Barein , Humanos , NucleotídeosRESUMO
HLA-DRB1*01:01:36 is a variant of DRB1*01:01:01, differing by three single nucleotide substitutions.
Assuntos
Sequenciamento de Nucleotídeos em Larga Escala , Doadores de Tecidos , Alelos , Éxons/genética , Cadeias HLA-DRB1/genética , HumanosRESUMO
Nucleotide sequence of HLA-A*26:206N differs from HLA-A*26:01:01 at genomic position g.1183 G>A.