Portuguese calculated panel reactive antibodies online estimator.

Abstract

Calculated panel reactive antibodies (CPRA) is a sensitization measure used to classify and prioritize transplant candidates in different kidney transplant allocation systems. CPRA is based on identification of HLA unacceptable on potential organ donors making a transplant candidate ineligible for transplantation. Here, we present a CPRA online estimator based on HLA allelic and haplotypic frequencies from Portuguese donors. We also compare the values we obtained from our CPRA estimator (Portuguese [PT]-CPRA) against CPRA values obtained from: Eurotransplant virtual PRA calculator (ET-CPRA); Canadian CPRA calculator (Canadian [CN]-CPRA) and Organ Procurement and Transplantation Network CPRA calculator (United States [US]-CPRA). When we analyzed correlations between CPRA values obtained from pairs of calculators, we observed that they are significantly and highly correlated. Bland-Altman plots for the comparison between PT-CPRA calculator against the other calculators, show higher differences between PT and CN than between PT and ET and PT and US. Also, the lowest value for Lin's concordance coefficient was obtained for the comparison between PT and CN calculators. CPRA values reliability depend on donors' pool from which it is calculated and it is crucial for classify correctly highly sensitized patients. A CPRA calculator must use donors' HLA frequencies similar from those who would be actual organ donors.