P.180: Results of CDC-XM and FCXM cross-match in highly sensitized patients with CKD.
Notice bibliographique
Résumé
A compatibility test is a necessary test that is performed before kidney transplantation to confirm the compatibility of the donor and recipient to prevent acute antibody-mediated rejection. CDC-XM may be false-positive in recipients with an autoimmune disease or in patients who have previously been treated with desensitization protocols such as rituximab, antithymocyte globulin, or intravenous immunoglobulins. Our aim was to examine the outcome of FCXM in highly sensitized CKD patients with positive CDC-XM. 5 patients with a high percentage of antibodies were studied and one patient with a negative HLA antibody status was taken as a control and received desensitizing therapy with a single administration of rituximab at a dose of 375 mg per body area. Antibodies were determined using Luminex technology (Luminex Corp., USA) and the SAB (single antigen bead) method (OneLambda, USA). SAB analysis, CDC-XM and FCXM were performed before and after rituximab therapy. For XM analyses, lymphocytes were isolated on a density gradient using negative selection cell isolation technology using RosetteSep kits (StemCell technologies, Canada). FCXM was supplied with FlowDSA-XM™ reagents (OneLambda, USA). SAB results before rituximab therapy were positive for class I and class II antibodies and ranged from 3 to 91%. The result after therapy showed a decrease in the percentage of antibodies of both classes and ranged from 0 to 60%. The results of the reaction of FCXM with serum obtained before and after rituximab therapy do not differ significantly. All results of the FCXM reaction are the same before and after trepapium, except for one patient in whom the cross-match with B cells was weakly positive before therapy, and showed a negative result after therapy. This is associated with a decrease in MFI levels of donor-specific antibodies DRB11 from 4901 to 1466 after receiving rituximab. There is a big difference from the results of CDC-XM with FCXM delivered with B cells. FCXM for the second class showed a negative result in all cases, while in CDC-XM a positive result was seen in all cases with an intensity of +4 to +8. It is assumed that the presence of rituximab in the serum did not affect the result of FCXM and therefore this type of analysis may be optimal for use in patients who received rituximab therapy without waiting for the drug to be eliminated from the body. Conversely, the CDC-XM assay should not be used in patients receiving rituximab and should only be administered after a drug washout time has been observed. The results obtained are intermediate; due to the insufficient number of observations, these studies will continue. In addition, in the future, the use of anti-rituximab monoclonal antibodies (Anti-Rituximab Antibody) is envisaged to inhibit rituximab in the patient’s serum before cross-match testing.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».