Universal Time: 16:22  |  Local Time: 16:22 (3h GMT)
Select your timezone:

HLA histocompatibility

Monday September 23, 2024 - 10:40 to 12:10

Room: Emirgan 1

221.6 Development of a calculated panel reactive antibody calculator for the United Arab Emirates

Gehad ElGhazali, United Arab Emirates

Consultant
Transplant Immunology
PureLab

Abstract

Development of a calculated panel reactive antibody calculator for the United Arab Emirates

Marion Alvares1, Siddiq Anwar4, Ayeda Al Mahri1, Al Yazia Al Qubaisi1, Zain Al Yafei1, Amar Khamis5, Ali Al Obaidli2, Muhammad Zaman3, Mohamed Al Seiari3, Gehad ElGhazali1.

1The Transplant Immunology Laboratory, PureLab, Purehealth, Abu Dhabi, United Arab Emirates; 2The National Center for Regulating Donation and Transplantation of Humans Organs and Tissues, MOH, Dubai, United Arab Emirates; 3Transplant Nephrology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; 4Internal Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates; 5Mohamed Bin Rashed University of Medicine and Medical Sciences, MBRU, Dubai, United Arab Emirates

Calculated panel reactive antibody (CPRA) is used to help increase sensitized patient’s access to transplantation. United Arab Emirates (UAE) has a diverse resident population hence we developed a UAE–CPRA calculator based on HLA antigen frequencies of the different ethnic groups that represent the UAE population. HLA antigen frequencies at serological split antigen level for HLA-A, -B, -C, -DRB1 and -DQB1 of 1002 healthy unrelated donors were performed. We subsequently compared the performance of the UAE CPRA calculator with the Organ Procurement and Transplantation Network (OPTN) and the Canadian CPRA calculators in 110 Kidney Transplant waitlist patients from January 2016 to December 2018. Lin’s concordance correlation coefficient showed a moderate agreement between the UAE and OPTN calculator (Rc = 0.949, 95% CI 0.929–0.963) and the UAE and Canadian calculators (Rc = 0.952, 95% CI 0.932–0.965). While there continued to be a moderate agreement (Rc = 0.937, UAE versus OPTN calculator) in the lower sensitized group, a poor agreement (Rc = 0.555, UAE versus OPTN calculator) was observed in the higher sensitized group. In this study, we provide a template for countries to develop their own population-specific CPRA calculator. Implementation of the CPRA algorithm based on HLA frequencies of the multi-ethnic UAE population will be more fitting to increase access to transplantation and improve transplant outcomes. Our study demonstrates that the CPRA calculators developed using the data from the western population had poor correlation in our higher sensitized patients disadvantaging them in potential organ allocations systems. We plan to further refine this calculator by using high resolution HLA typing to address the problem of a genetically diverse population.

Presentations by Gehad ElGhazali

The WebApp is sponsored by