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Virtual and Reality: An Analysis of the UCLA Virtual Crossmatch Exchanges
The “virtual” crossmatch (VXM) has become a critical tool to predict the compatibility between an organ donor and a potential recipient. Yet, nonstandardized laboratory practice can lead to variability in VXM interpretation. Therefore, UCLA’s VXM Exchange survey was designed to understand factors th...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10358445/ https://www.ncbi.nlm.nih.gov/pubmed/36944607 http://dx.doi.org/10.1097/TP.0000000000004586 |
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author | Locke, Arlene F. Hickey, Michelle Valenzuela, Nicole M. Butler, Carrie Sosa, Rebecca Zheng, Ying Gjertson, David Reed, Elaine F. Zhang, Qiuheng |
author_facet | Locke, Arlene F. Hickey, Michelle Valenzuela, Nicole M. Butler, Carrie Sosa, Rebecca Zheng, Ying Gjertson, David Reed, Elaine F. Zhang, Qiuheng |
author_sort | Locke, Arlene F. |
collection | PubMed |
description | The “virtual” crossmatch (VXM) has become a critical tool to predict the compatibility between an organ donor and a potential recipient. Yet, nonstandardized laboratory practice can lead to variability in VXM interpretation. Therefore, UCLA’s VXM Exchange survey was designed to understand factors that influence the variability of VXM prediction in the presence of HLA donor-specific antibody (DSA). Thirty-six donor blood samples and 72 HLA reference sera were sent to 35 participating laboratories to perform HLA antibody testing, flow crossmatch (FXM), and VXM from 2014 to 2019, consisting of 144 T/B-cell FXM pairs and 112 T/B-cell VXM pairs. In the FXM survey, 86% T-cell FXM and 84% B-cell FXM achieved >80% concordance among laboratories. In the VXM survey, 81% T-cell VXM and 80% VXM achieved >80% concordance. The concordance between FXM and VXM was 79% for T cell and 87% for B cell. The consensus between VXM and FXM was high with strong DSA. However, significant variability was observed in sera with (1) very high titer antibodies that exit prozone effect; (2) weak-to-moderate DSA, particularly in the presence of multiple weak DSAs; and (3) DSA against lowly expressed antigens. With the increasing use the VXM, standardization and continuous learning via exchange surveys will provide better understanding and quality controls for VXM to improve accuracy across all centers. |
format | Online Article Text |
id | pubmed-10358445 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-103584452023-07-21 Virtual and Reality: An Analysis of the UCLA Virtual Crossmatch Exchanges Locke, Arlene F. Hickey, Michelle Valenzuela, Nicole M. Butler, Carrie Sosa, Rebecca Zheng, Ying Gjertson, David Reed, Elaine F. Zhang, Qiuheng Transplantation Original Clinical Science—General The “virtual” crossmatch (VXM) has become a critical tool to predict the compatibility between an organ donor and a potential recipient. Yet, nonstandardized laboratory practice can lead to variability in VXM interpretation. Therefore, UCLA’s VXM Exchange survey was designed to understand factors that influence the variability of VXM prediction in the presence of HLA donor-specific antibody (DSA). Thirty-six donor blood samples and 72 HLA reference sera were sent to 35 participating laboratories to perform HLA antibody testing, flow crossmatch (FXM), and VXM from 2014 to 2019, consisting of 144 T/B-cell FXM pairs and 112 T/B-cell VXM pairs. In the FXM survey, 86% T-cell FXM and 84% B-cell FXM achieved >80% concordance among laboratories. In the VXM survey, 81% T-cell VXM and 80% VXM achieved >80% concordance. The concordance between FXM and VXM was 79% for T cell and 87% for B cell. The consensus between VXM and FXM was high with strong DSA. However, significant variability was observed in sera with (1) very high titer antibodies that exit prozone effect; (2) weak-to-moderate DSA, particularly in the presence of multiple weak DSAs; and (3) DSA against lowly expressed antigens. With the increasing use the VXM, standardization and continuous learning via exchange surveys will provide better understanding and quality controls for VXM to improve accuracy across all centers. Lippincott Williams & Wilkins 2023-07-20 2023-08 /pmc/articles/PMC10358445/ /pubmed/36944607 http://dx.doi.org/10.1097/TP.0000000000004586 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Original Clinical Science—General Locke, Arlene F. Hickey, Michelle Valenzuela, Nicole M. Butler, Carrie Sosa, Rebecca Zheng, Ying Gjertson, David Reed, Elaine F. Zhang, Qiuheng Virtual and Reality: An Analysis of the UCLA Virtual Crossmatch Exchanges |
title | Virtual and Reality: An Analysis of the UCLA Virtual Crossmatch Exchanges |
title_full | Virtual and Reality: An Analysis of the UCLA Virtual Crossmatch Exchanges |
title_fullStr | Virtual and Reality: An Analysis of the UCLA Virtual Crossmatch Exchanges |
title_full_unstemmed | Virtual and Reality: An Analysis of the UCLA Virtual Crossmatch Exchanges |
title_short | Virtual and Reality: An Analysis of the UCLA Virtual Crossmatch Exchanges |
title_sort | virtual and reality: an analysis of the ucla virtual crossmatch exchanges |
topic | Original Clinical Science—General |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10358445/ https://www.ncbi.nlm.nih.gov/pubmed/36944607 http://dx.doi.org/10.1097/TP.0000000000004586 |
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