A database application for donor-recipient HLA match used in kidney transplantation

摘要

The outcome of kidney transplants from unrelated live donors or from cadaver kidneys have been reported to be strongly influenced by HLA compatibility. Due to the difficulty of allocation of kidneys for identical HLA match, to increase patients' chances of receiving transplants, consequently, matching has been proposed of deduced amino acid residues of the individual HLA molecules shared by cross-reactive antigen groups(CREGs). Currently many hospitals in China use serological method for HLA typing, some of them use DNA based technology for HLA typing. But most hospitals in China perform HLA matching manually. We have developed a database application system with a program which can quickly find the most suitable individuals in need of kidney transplants from the waiting list for an available donor. Besides 0-3 mismatch of HLA-A,B, and DR, the program works with a criteria of CREGs and permissible HLA-DR mismatch. We noticed some different definitions of CREGs in the literatures and some divergence of views about permissible mismatch concept, it is also our goal to evaluate above criteria with statistical clinical results. Our system also covers virtually all aspects to meet the requirements of most hospitals' urological departments. Its features include patient information management, various statistical reports, and so on. Currently it is in use at two famous hospitals in China.