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Virtual Reality Experiments with Physiological Measures
Published on: August 29, 2018
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Virtual Crossmatch: Reality of Perception.
M Alzahrani1, Z Qahtani1, H Harbi1
1Histocompatibility and Immunogenetic Laboratory, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia.
Transplantation Proceedings
|March 19, 2019
Summary
Virtual flow crossmatches (vFXMs) accurately predict kidney transplant compatibility in most cases. This method, using single antigen bead assay, can safely guide kidney offer allocation, reducing the need for physical crossmatches.
Area of Science:
- Nephrology
- Immunology
- Transplantation Science
Background:
- Kidney transplantation is a vital treatment for end-stage renal disease.
- Accurate pre-transplant crossmatching is crucial to prevent antibody-mediated rejection.
- Traditional actual flow crossmatches (aFXMs) can cause delays in organ allocation.
Purpose of the Study:
- To evaluate the concordance between virtual flow crossmatches (vFXMs) and aFXMs.
- To assess the reliability of vFXMs in predicting transplant outcomes.
- To determine if vFXMs can be safely used to allocate kidney offers.
Main Methods:
- Retrospective analysis of 773 aFXMs and vFXMs in kidney transplantation.
- vFXM prediction based on single antigen bead assay and a defined mean fluorescence intensity cutoff.
- Comparison of vFXM predictions against donor HLA antigens.
Main Results:
- High overall concordance (97%) between vFXMs and aFXMs.
- Twenty-three cases showed discordance: 12 with 0% calculated panel-reactive antibody and 11 with multiple non-donor-specific HLA antibodies.
- Three cases predicted positive by vFXM were negative by aFXM, with two involving allele-specific antibodies.
Conclusions:
- vFXMs, utilizing precise antibody specificity characterization, accurately predict aFXMs in the majority of kidney transplant candidates.
- The established vFXM protocol can be safely implemented for selected patients.
- vFXMs offer a reliable alternative to physical crossmatches, potentially streamlining kidney offer allocation.
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