Research Papers: Immunology:
Correlation and agreement between eplet mismatches calculated using serological, low-intermediate and high resolution molecular human leukocyte antigen typing methods
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Samantha Fidler1,2, Lloyd D’Orsogna1,2, Ashley B. Irish3,4, Joshua R. Lewis4,5,6, Germaine Wong5,6,7 and Wai H. Lim4,8
1Department of Clinical Immunology, Fiona Stanley Hospital, Perth, Australia
2School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia
3Department of Nephrology and Transplantation, Fiona Stanley Hospital, Perth, Australia
4School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
5Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia
6Sydney School of Public Health, University of Sydney, Sydney, Australia
7Centre for Transplant and Renal Research, Westmead Hospital, Sydney, Australia
8Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia
Wai H. Lim, email: firstname.lastname@example.org
Keywords: HLA typing; serological; molecular; agreement; Immunology section
Received: October 16, 2017 Accepted: January 24, 2018 Published: February 01, 2018
Structural human leukocyte antigen (HLA) matching at the eplet level can be identified by HLAMatchmaker, which requires the entry of four-digit alleles. The aim of this study was to evaluate the agreement between eplet mismatches calculated by serological and two-digit typing methods compared to high-resolution four-digit typing. In a cohort of 264 donor/recipient pairs, the evaluation of measurement error was assessed using intra-class correlation to confirm the absolute agreement between the number of eplet mismatches at class I (HLA-A, -B, C) and II loci (HLA-DQ and -DR) calculated using serological or two-digit molecular typing compared to four-digit molecular typing methods. The proportion of donor/recipient pairs with a difference of >5 eplet mismatches between the HLA typing methods was also determined. Intra-class correlation coefficients between serological and four-digit molecular typing methods were 0.969 (95% confidence intervals [95% CI] 0.960–0.975) and 0.926 (95% CI 0.899–0.944), respectively; and 0.995 (95% CI 0.994–0.996) and 0.993 (95% CI 0.991–0.995), respectively between two-digit and four-digit molecular typing methods. The proportion of donor/recipient pairs with a difference of >5 eplet mismatches at class I and II loci was 4% and 16% for serological versus four-digit molecular typing methods, and 0% and 2% for two-digit versus four-digit molecular typing methods, respectively. In this small predominantly Caucasian population, compared with serology, there is a high level of agreement in the number of eplet mismatches calculated using two-compared to four-digit molecular HLA-typing methods, suggesting that two-digit typing may be sufficient in determining eplet mismatch load in kidney transplantation.
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