Introduction: Transplantation opportunities for sensitized patients remain a significant challenge in Argentina. To address this, we developed the Argentinean Calculated Panel Reactive Antibody (cPRA) calculator. This innovation aimed to enhance transplantation access for sensitized patients by leveraging a prototype database containing HLA antigen data from deceased donor donations in 2022. Given Argentina's diverse genetic landscape, capturing specific HLA antigens and frequencies unique to the nation was imperative.
Method: This study included 228 HLA typings (HLA-A, HLA-B, HLA-DRB1, and HLA-DQB1) of deceased donors conducted between January 1st, 2022, and December 31st, 2022. All typings were performed at the Provincial Centre of Histocompatibility from CUCAIBA using PCR sequence-specific primer (PCR-SSP) methodology. Additionally, Single Antigen reports conducted at the Provincial Centre of Histocompatibility from CUCAIBA over a three-month period (January-March 2022) from 29 patients were included in this study.
Results: Upon development, the Argentinean cPRA calculator underwent rigorous validation against international counterparts, namely the OPTN cPRA and Eurotransplant vPRA calculators. The results revealed robust agreement, with high concordance coefficients (rc) of 0.992 for PRA I and 0.985 for PRA II with OPTN cPRA, and 0.989 for PRA I and 0.993 for PRA II with Eurotransplant vPRA. These findings signify the calculator's precision and reliability in assessing sensitization phases, offering valuable insights for organ allocation systems.
Conclusion: The development and validation of the Argentinean cPRA calculator represent a pioneering effort, introducing a population-specific algorithm grounded in Argentina's unique HLA frequencies. Future refinements, including the unification of PRA I and PRA II into a single value, are planned to align Argentina's leap into the cPRA era with calculators worldwide. The Argentinean calculator holds promise in optimizing transplantation access and outcomes for sensitized patients in Argentina, addressing a critical need in the transplantation landscape.