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2015년 국내 HLA 교차시험 현황 설문조사

A Questionnaire Survey of HLA Crossmatch Tests in Korea (2015)

박명희|강은숙|유신애
대한진단검사의학회 (Korean Society For Laboratory Medicine)|2017.07|Laboratory Medicine Online|제7권 제3호|pp. 147-156

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참고문헌

키워드

StandardizationQuestionnaire surveyFlow cytometryHLA crossmatchComplement-dependent cytotoxicity

초록

배경: HLA 교차시험(HLA crossmatch, HLA-XM) 표준화를 위한설문조사의 자료를 분석하여 HLA-XM을 시행하는 국내 기관의현황을 파악하고, 나아가 HLA-XM의 표준화를 이루기 위한 기초자료로 사용하고자 하였다. 방법: 2015년 8월을 기준으로 국내 HLA 검사 신빙도조사 중 HLAXM에참여하고 있는 51개의 의료기관을 대상으로 설문조사를 시행하여, 응답한 50개 기관을 대상으로 결과를 분석하였다. 설문항목은 1) 시행 중인 HLA-XM 종류와 연간 검사 건수, 2) HLA-XM 에 사용하는 검체의 종류와 림프구 분리방법, 3) 보체의존성 세포독성 교차시험(complement-dependent cytotoxicity crossmatch, CDC-XM) 및 유세포분석 교차시험(flow cytometry crossmatch, FCXM)의 검사방법 및 시약에 대해 조사하였다. 결과: Anti-human globulin (AHG) CDC-XM (47/49, 96%)과 FCXM (30/50, 60%)을 시행하고 있는 기관은 2005년 설문조사(AHG CDCXM, 35/43, 81%; FCXM, 7/44, 16%)에 비해 현저히 증가하였다. 연간 검사건수에서 50% 이상의 기관이 50건 이하를 실시하는 소규모 검사실에 속했고, 연간 500건을 넘는 검사를 실시하는 곳은10%에 불과했다. 세포 분리방법에 있어서는 CDC-XM을 실시하는기관의 43% (21/49)에서 negative selection 방법을 사용하고 있었다. 혈청 1 μL당 반응시키는 세포 수는 CDC-XM (1,000-8,000)과FCXM (1,300-20,000) 모두에서 넓은 범위의 분포를 보였다. FCXM 의 결과 판정에서 log 형광값 비율(log fluorescence ratio)을 사용하는 기관(26/30, 87%)이 channel shift 값을 사용하는 기관(5/30, 17%)에 비해 더 많았다. 결론: CDC-XM과 FCXM 모두에서 서로 다른 기관에서 사용하는검사방법이나 판정 기준에 상당한 차이가 있는 것이 확인되었다. 기관별 검사결과의 차이를 줄이기 위하여 HLA-XM의 표준화 작업을 지속적으로 시행하여야 할 것이다.

Abstract

Background: We carried out a questionnaire survey for laboratories performing human leukocyte antigen-crossmatch (HLA-XM) to provide a basis for laboratory standardization of HLA-XM tests in Korea. Methods: The questionnaires were distributed to 51 HLA laboratories participating in the HLA-XM part of the HLA proficiency survey program organized by the Korean Society for Laboratory Medicine and replies from 50 laboratories were analyzed. The questionnaires included following items: 1) HLA-XM methods performed and annual number of tests, 2) types of the specimen and lymphocyte separation methods, 3) test procedures and reagents for complement-dependent cytotoxicity crossmatch (CDC-XM) and flow cytometry crossmatch (FCXM). Results: The number of laboratories performing anti-human globulin (AHG) CDC-XM (47/49, 96%) and FCXM (30/50, 60%) was considerably increased compared to the 2005 survey (AHG CDC-XM, 35/43, 81%; FCXM, 7/44, 16%). As for the annual number of XM tests, more than 50% of the laboratories were low volume laboratories performing ≤50 tests, and only 10% of the laboratories were performing >500 tests. For cell isolation methods, negative selection was used by 43% (21/49) of laboratories performing CDC-XM. Number of cells reacted per 1 μL of serum varied among different laboratories in both CDC-XM (1,000–8,000) and FCXM tests (1,300-20,000). For the interpretation of FCXM, log fluorescence ratio (26/30, 87%) was more commonly used than channel shift values (5/30, 17%). Conclusions: Considerable variation is noted in both CDC-XM and FCXM methods performed by different laboratories. A continuous effort for laboratory standardization is needed to reduce inter-laboratory variation in the HLA-XM test results.

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관련 논문AI추천

전국 HLA 검사실 현황 설문조사(2005)오흥범, 임지훈, 황상현대한진단검사의학회 · Annals of Laboratory Medicine2005 · 제25권 제6호장기이식 시 유세포분석법에 의한 HLA 교차시험의 양성례 분석원동일, 이윤수대한진단검사의학회 · Laboratory Medicine Online2011 · 제1권 제1호HLA 검사 신빙도조사 결과(2000-2002년)김병철, 박명희, 한복연대한진단검사의학회 · Annals of Laboratory Medicine2005 · 제25권 제5호Human Leukocyte Antigen 검사 신빙도조사 결과(2005-2006년)김명희, 오흥범, 최성은대한진단검사의학회 · Annals of Laboratory Medicine2007 · 제27권 제6호HLA 동종항체 선별을 위한 ELISA 및 Luminex Panel Reactive Antibody 검사의 비교평가김용구, 박연준, 안웅식, 양철우, 오은지, 한경자, 정선경1대한진단검사의학회 · Annals of Laboratory Medicine2009 · 제29권 제5호HLA Class II 항체 검출 시 C3d 검사법과 SAB 검사법의 상관관계 평가강혜인, 김도훈, 류남희, 이원목, 전동석, 하정숙대한진단검사의학회 · Laboratory Medicine Online2020 · 제10권 제4호

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