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Utilizing proficiency testing survey data to create advanced educational content: the virtual crossmatch challenge model
Proficiency testing (PT) surveys include data from laboratories across the world and are ideal for creating advanced educational content, beyond just consensus grading. Educational challenges provide a unique opportunity to probe common laboratory practices and risk assessment, especially in cases w...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10552184/ https://www.ncbi.nlm.nih.gov/pubmed/37811147 http://dx.doi.org/10.3389/fgene.2023.1256498 |
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author | Hod-Dvorai, Reut Philogene, Mary Carmelle Timofeeva, Olga Gimferrer, Idoia Dunckley, Heather Greenshields, Anna Jindra, Peter |
author_facet | Hod-Dvorai, Reut Philogene, Mary Carmelle Timofeeva, Olga Gimferrer, Idoia Dunckley, Heather Greenshields, Anna Jindra, Peter |
author_sort | Hod-Dvorai, Reut |
collection | PubMed |
description | Proficiency testing (PT) surveys include data from laboratories across the world and are ideal for creating advanced educational content, beyond just consensus grading. Educational challenges provide a unique opportunity to probe common laboratory practices and risk assessment, especially in cases where there is no “analyte” tested. Human leukocyte antigen (HLA) compatibility evaluation between donor and recipient pairs has been traditionally assessed using T-cell and B-cell physical crossmatches. However, advancements in our ability to identify and characterize HLA antibodies using solid phase assays, in combination with changing deceased donor allocation schemes and improved HLA typing, have shifted the paradigm from performing physical crossmatches to the use of the virtual crossmatch (VXM). VXM is a compatibility assessment relying on the interpretation of pre-transplant HLA laboratory data and as such, it is not an “analyte”. However, VXM results are used in clinical decision-making. The VXM assessment depends on patient characteristics as well as laboratory and transplant center practices but must ensure safe transplantation outcomes while maintaining equity in access to transplantation. In this manuscript, we describe the American Society for Histocompatibility and Immunogenetics (ASHI) PT Educational VXM Challenge, as a model for creating educational content using PT survey data. We discuss the different components of the VXM Challenge and highlight major findings and learning points acquired from ASHI VXM Challenges performed between 2018–2022, such as the lack of correlation between the VXM and the physical crossmatch in the presence of low level donor-specific antibodies (DSA), or when the DSA were aimed against donor alleles that are not present on the antibody panel, and in the presence of an antibody to a shared eplet. Finally, we show that the VXM Educational Challenge serves as a valuable tool to highlight the strengths and pitfalls of the VXM assessment and reveals differences in testing and result interpretation among participating HLA laboratories. |
format | Online Article Text |
id | pubmed-10552184 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-105521842023-10-06 Utilizing proficiency testing survey data to create advanced educational content: the virtual crossmatch challenge model Hod-Dvorai, Reut Philogene, Mary Carmelle Timofeeva, Olga Gimferrer, Idoia Dunckley, Heather Greenshields, Anna Jindra, Peter Front Genet Genetics Proficiency testing (PT) surveys include data from laboratories across the world and are ideal for creating advanced educational content, beyond just consensus grading. Educational challenges provide a unique opportunity to probe common laboratory practices and risk assessment, especially in cases where there is no “analyte” tested. Human leukocyte antigen (HLA) compatibility evaluation between donor and recipient pairs has been traditionally assessed using T-cell and B-cell physical crossmatches. However, advancements in our ability to identify and characterize HLA antibodies using solid phase assays, in combination with changing deceased donor allocation schemes and improved HLA typing, have shifted the paradigm from performing physical crossmatches to the use of the virtual crossmatch (VXM). VXM is a compatibility assessment relying on the interpretation of pre-transplant HLA laboratory data and as such, it is not an “analyte”. However, VXM results are used in clinical decision-making. The VXM assessment depends on patient characteristics as well as laboratory and transplant center practices but must ensure safe transplantation outcomes while maintaining equity in access to transplantation. In this manuscript, we describe the American Society for Histocompatibility and Immunogenetics (ASHI) PT Educational VXM Challenge, as a model for creating educational content using PT survey data. We discuss the different components of the VXM Challenge and highlight major findings and learning points acquired from ASHI VXM Challenges performed between 2018–2022, such as the lack of correlation between the VXM and the physical crossmatch in the presence of low level donor-specific antibodies (DSA), or when the DSA were aimed against donor alleles that are not present on the antibody panel, and in the presence of an antibody to a shared eplet. Finally, we show that the VXM Educational Challenge serves as a valuable tool to highlight the strengths and pitfalls of the VXM assessment and reveals differences in testing and result interpretation among participating HLA laboratories. Frontiers Media S.A. 2023-09-21 /pmc/articles/PMC10552184/ /pubmed/37811147 http://dx.doi.org/10.3389/fgene.2023.1256498 Text en Copyright © 2023 Hod-Dvorai, Philogene, Timofeeva, Gimferrer, Dunckley, Greenshields and Jindra. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Genetics Hod-Dvorai, Reut Philogene, Mary Carmelle Timofeeva, Olga Gimferrer, Idoia Dunckley, Heather Greenshields, Anna Jindra, Peter Utilizing proficiency testing survey data to create advanced educational content: the virtual crossmatch challenge model |
title | Utilizing proficiency testing survey data to create advanced educational content: the virtual crossmatch challenge model |
title_full | Utilizing proficiency testing survey data to create advanced educational content: the virtual crossmatch challenge model |
title_fullStr | Utilizing proficiency testing survey data to create advanced educational content: the virtual crossmatch challenge model |
title_full_unstemmed | Utilizing proficiency testing survey data to create advanced educational content: the virtual crossmatch challenge model |
title_short | Utilizing proficiency testing survey data to create advanced educational content: the virtual crossmatch challenge model |
title_sort | utilizing proficiency testing survey data to create advanced educational content: the virtual crossmatch challenge model |
topic | Genetics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10552184/ https://www.ncbi.nlm.nih.gov/pubmed/37811147 http://dx.doi.org/10.3389/fgene.2023.1256498 |
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