Utility of Virtual Crossmatch in Sensitized Patients Awaiting Heart Transplantation

被引：62

作者：

Stehlik, Josef ^{[1
,2
]}

Islam, Nauman ^{[2
]}

Hurst, Denise ^{[2
]}

Kfoury, Abdallah G. ^{[3
]}

Movsesian, Matthew A.

Fuller, Ann ^{[2
]}

Delgado, Julio C. ^{[2
]}

Hammond, Elizabeth H. ^{[3
]}

Gilbert, Edward M. ^{[2
]}

Renlund, Dale G. ^{[3
]}

Bader, Feras ^{[2
]}

Fisher, Patrick W. ^{[3
]}

Bull, David A. ^{[2
]}

Singhal, Arun K. ^{[2
]}

Eckels, David D. ^{[2
]}

机构：

[1] Univ Utah Hlth Sci, VA Salt Lake City Hlth Care Syst, Cardiol Sect 111CT, Heart Failure & Transplant Off,UTAH Cardiac Trans, Salt Lake City, UT 84148 USA

[2] Univ Utah Hosp, UTAH Cardiac Transplant Program, Salt Lake City, UT USA

[3] Intermt Med Ctr, UTAH Cardiac Transplant Program, Salt Lake City, UT USA

来源：

JOURNAL OF HEART AND LUNG TRANSPLANTATION | 2009年 / 28卷 / 11期

关键词：

INTRAVENOUS IMMUNE GLOBULIN; RENAL-ALLOGRAFT RECIPIENTS; HLA-SPECIFIC ANTIBODIES; KIDNEY-TRANSPLANTATION; ASSIST DEVICES; FLOW-CYTOMETRY; LIVING-DONOR; DESENSITIZATION; ALLOSENSITIZATION; IDENTIFICATION;

D O I：

10.1016/j.healun.2009.05.031

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Background: Organ transplant candidates with serum antibodies directed against human leukocyte antigens (HLA) face longer waiting times and higher mortality while awaiting transplantation. This study examined the accuracy of virtual crossmatch, in which recipient HLA-specific antibodies, identified by solid-phase assays, are compared to the prospective donor HLA-type in heart transplantation. Methods: We examined the accuracy of virtual crossmatch in predicting immune compatibility of donors and recipients in heart transplantation and clinical outcomes in immunologically sensitized heart transplant recipients in whom virtual crossmatch was used in allograft allocation. Results: Based on analysis of 257 T-cell antihuman immunoglobulin complement-dependent cytotoxic (AHG-CDC) crossmatch tests, the positive predictive value of virtual crossmatch (the likelihood of an incompatible virtual crossmatch resulting in an incompatible T-cell CDC-AHG crossmatch) was 79%, and the negative predictive value of virtual crossmatch (the likelihood of a compatible virtual crossmatch resulting in a compatible T-cell CDC-AHG crossmatch) was 92%. When used in a cohort of 28 sensitized patients awaiting heart transplantation, 14 received allografts based on a compatible virtual crossmatch alone from donors in geographically distant locations. Compared with the other 14 sensitized patients who underwent transplant after a compatible prospective serologic crossmatch, the rejection rates and survival were similar. Conclusion: Our findings are evidence of the accuracy of virtual crossmatch and its utility in augmenting the opportunities for transplantation of sensitized patients. J Heart Lung Transplant 2009;28:1129-34. Copyright (C) 2009 by the International Society for Heart and Lung Transplantation. Copyright (C) 2009 by the International Society for Heart and Lung Transplantation.

引用

页码：1129 / 1134

页数：6

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