CORRELATION AND AGREEMENT BETWEEN THE NUMBER OF CLASS I AND II EPLET MISMATCHES CALCULATED USING SEROLOGICAL, LOW-INTERMEDIATE AND HIGH RESOLUTION MOLECULAR HUMAN LEUKOCYTE ANTIGEN TYPING METHODS

S FIDLER1, L D’ORSOGNA1, AB IRISH2, J LEWIS3, G WONG4, WH LIM5

1Department of Clinical Immunology, Fiona Stanley Hospital, Perth; 2 Department of Renal Medicine, Fiona Stanley Hospital, Perth; 3Centre for Kidney Research & Department of Renal Medicine, Westmead Hospital, Sydney; 4Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth

Aim: To evaluate the agreement between eplet mismatches calculated by serological and two-digit typing methods compared to high-resolution four-digit typing method.

Background: Structural human leukocyte antigen (HLA) matching at the eplet level can be identified by HLAMatchmaker, but requires the entry of four-digit allele typing, which are often not practicable in donor kidney allocation because of time constraint.

Methods: 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.

Results: 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 <1% and 2% for two-digit versus four-digit molecular typing methods, respectively.

Conclusions: 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.

About ANZSN

The ASM is hosted by Australian and New Zealand Society of Nephrology.

The aims of the Society are to promote and support the study of the kidney and urinary tract in health and disease, and to ensure the highest professional standards for the practice of nephrology in Australia and New Zealand.

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