利用中、高分辨HLA分型方法计算供受者Eplet错配的一致性研究

Calculation of Eplet mismatch by intermediate and high-resolution HLA typing

目的评估利用中、高分辨人类白细胞抗原(HLA)分型方法计算供受者功能性表位(Eplet)错配的一致性。方法收集2015年1月至2019年12月西安交通大学第一附属医院实施肾移植1487例供、受者HLA中、高分辨分型资料,利用HLA Matchmaker软件计算Eplet错配数,比较供、受者中、高分辨HLA配型Eplet错配数的一致性。测定HLA分型方法之间存在Eplet错配差异的供、受者比例。结果供受者HLA中分辨Ⅰ类和Ⅱ类位点Eplet错配的中位数分别为14(0~38)和8(0~24);HLA高分辨Ⅰ类和Ⅱ类位点Eplet错配的中位数分别为14(0~38)和7(0~23)。使用中分辨和高分辨分型方法计算的HLAⅠ类[95%置信区间(CI):0.989(0.988~0.991)]和Ⅱ类[95%CI:0.990(0.989~0.992)]位点的Eplet错配数的相对一致性和绝对一致性都非常相似。两种方法计算的HLAⅠ和Ⅱ类分子Eplet错配数差别在0~2个之间的供、受者的比例分别为92.5%和97.5%,Eplet错配数差别≥3的供、受者比例分别为7.5%和2.5%。结论利用供、受者HLA中分辨分型及高分辨分型计算Eplet错配数的一致性较好;HLA中分辨分型转换为HLA高分辨分型所计算的Eplet错配数与实际Eplet错配数基本一致。

Objective To evaluate the consistency of donor/recipient Eplet mismatch calculated by intermediate and high-resolution HLA typing.Methods From January 2015 to December 2019,1487 cases of kidney transplantation were selected for calculating the Eplet mismatch number by using HLA Matchmaker software in order to compare the consistency of Eplet mismatch number of donor/recipient between intermediate and high-resolution HLA typing.The proportion of recipients with Eplet mismatch differences were determined between intermediate and high-resolution HLA typing.Results The interquartile range(IQR)of Eplet mismatch of intermediate-resolution HLAⅠandⅡwas 14(0~38)and 8(0~24)and 14(0~38)and 7(0~23)for high-resolution HLAⅠandⅡrespectively.The consistency and absolute agreement of Eplet mismatch at HLA class I[95%CI:0.989(0.988~0.991)]and HLA classⅡ[95%CI:0.990(0.989~0.992)]sites were very similar between intermediate and high-resolution HLA typing methods.The donor/recipient proportions of HLA classⅠ/Ⅱmolecule Eplet mismatch differences between 0 and 2 were 92.5%and 97.5%respectively.The proportions of recipient/donor with Eplet mismatch equal or over 3 were 7.5%and 2.5%respectively.Conclusions As calculated by using intermediate and high-resolution HLA typing,the consistency and absolute agreement of Eplet mismatch number are excellent.And the count of Eplet mismatch calculated by HLA intermediate typing converting into HLA high-resolution typing is basically consistent with actual Eplet mismatch.