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Assessment of access and outcomes of kidney transplantation through the reforms of the Swiss organ allocation system.
Front Public Health
January 2025
Transplant Immunology Unit, Geneva University Hospitals, Geneva, Switzerland.
Introduction: The Swiss allocation system for kidney transplantation has evolved over time to balance medical urgency, immunological compatibility, and waiting time. Since the introduction of the transplantation law in 2007, which imposed organ allocation on a national level, the algorithm has been optimized. Initially based on waiting time, HLA compatibility, and crossmatch performed by cell complement-dependent cytotoxicity techniques, the system moved in 2012 to a score including HLA compatibility, waiting time, anti-HLA antibodies detected by the Luminex technology, and a virtual crossmatch.
View Article and Find Full Text PDFThe degree of immunological compatibility between donors and recipients greatly impacts allograft survival. In the United States kidney allocation system, HLA antigen-level matching has been shown to cause ethnic disparities and thus, has been de-emphasised. However, priority points are still awarded for antigen-level zero-ABDR matching, zero-DR matching and one-DR matching.
View Article and Find Full Text PDFHLA Compatibility and Graft Survival Rates Among Related and Unrelated Donors in Renal Transplantation.
Transplant Proc
December 2024
School of Biotechnology, International University, Vietnam National University Ho Chi Minh City, Vietnam; Research Center for Infectious Diseases, International University, Vietnam National University Ho Chi Minh City, Vietnam.
Human leukocyte antigen (HLA) compatibility between donors and recipients plays a critical role in graft survival in renal transplantation. This study evaluates the impact of HLA mismatching on graft survival and rejection among renal transplant recipients with related and unrelated donors, considering factors such as age, sex, ABO blood type, and anti-HLA antibodies. We investigated the graft survival rates between related and unrelated donors in a prospective cohort study conducted from 2018 to 2020 at Cho Ray Hospital and People's Hospital 115 in Vietnam, involving 126 related and 82 unrelated donor-recipient pairs.
View Article and Find Full Text PDFThe Importance of Confirming False Homozygosity in Pretransplant HLA Typing Results of Patients with Hematologic Malignancies.
Int J Med Sci
October 2024
Department of Laboratory Medicine, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea.
Loss of heterozygosity (LOH) on chromosome 6p, where the HLA genes are located, can result in incorrect homozygosity findings during HLA genotyping in patients with hematologic malignancies. The degree of HLA compatibility between donor and recipient is crucial in hematopoietic stem cell transplantation. Therefore, we present a case of false homozygosity in HLA genotyping due to LOH on chromosome 6p in a patient diagnosed with acute myeloid leukemia (AML).
View Article and Find Full Text PDFRefining cPRA calculation to improve HLA compatibility assessment in organ transplantation: A detailed picture of the Paris waiting list.
HLA
September 2024
Laboratoire d'Immunologie et Histocompatibilité, Hôpital Saint Louis, Paris, France.
The determination of panel reactive antibodies (cPRA) scores plays a critical role in assessing the immunological compatibility between organ transplant recipients and potential donors. Traditional cPRA methods focus on a limited number of HLA loci using physical cytotoxicity tests. However, advancements such as the Luminex single antigen (LSA) assay, which uses mean fluorescence intensity (MFI) of individualised HLA antigens for antibody evaluation, provide a foundation for a more precise assessment.
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