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Abstract
Background
Panel reactive antibody (PRA) test is used to determine whether a patient awaiting transplantation is previously sensitized. Tail analysis algorithm is widely used to identify antibody specificities, but it is very difficult to perform manually.
Methods
To develop a web-based program, PHP (5.1.2), Apache (2.0.55), and MySQL (5.0.22) were used. Tail analysis algorithm was applied to identify specificities, which analyzed statistically 2×2 tables representing reactivities to broad antigens, splits and cross reactive groups (CREG). Exploiting two CREG classifications of Rodey (R) and Takemoto (T), antibody specificities were identified by 3 methods (ABC, R-ABC, T-ABC) simultaneously. Performance of the system was evaluated using 159 samples that showed ≥6 PRA% by a lymphocytotoxicity assay.
Results
A web-based system that can identify HLA antibody specificities was implemented on www.koreanhla.com. Among 159 samples tested, antibody specificities were identified in 151 (95.0 %), but not in 8 samples with PRA >97%. Among the 151 samples, 110 showed broad or split specificities and 41 CREG specificities.
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Table 1.
2×2 contingency table
| Antigen “X” on cells | ||||
|---|---|---|---|---|
| + | - | |||
| Reactions of serum “Y” | + | a | b | a+b |
| - | c | d | c+d | |
| a+c | b+d | a+b+c+d=n | ||
a=number of panel cells with antigen × that react with serum Y. b=number of panel cells lacking antigen × that react with serum Y (false positives). c=number of panels cells with antigen × with fail to react with serum Y (false negatives). d=number of panel cells that lack antigen × and fail to react with serum Y. a+b=the total number of positive reactions. c+d=the total number of negative reactions. a+c=the total number of cells carrying the antigen. b+d=the total number of cells lacking the antigen. a+b+c+d=n=total number of comparisons. The value of Chi-square can be computed according to the general formula: χ2=(ad-bc)2n/(a+b)(c+d)(a+c)(b+d).
Table 2.
Broad specificities and splits for HLA-A, -B
Table 3.
Rodey CREG classification
Table 4.
Takemoto CREG classification
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