Official Sections CTRMS ISVCA IPITA IPTA ISODP IRTA IXA SPLIT TID

2018 - Online Interactive Update Course (en, sp, pt)


This page contains exclusive content for the member of the following sections: TTS, CTS, IPITA, ISODP, IXA, ITA, TID, IHCTAS, IPTA, SPLIT

Laboratory Tests

2.5 - Integrating DSA Characteristics in Clinical Management: Step Towards Precision Medicine

Presenter: Adriana, Zeevi, , United States
Authors: Adriana Zeevi

[en] In recent years, significant technological and scientific changes occurred in the laboratory tests, to assess the risks and magnitude in post-transplantation rejection and the follow-up of transplant patients, in their evolution and/or undergoing anti-rejection therapy.

The ‘zone’ factor, the role of complement in the tests, the differences in the assessment tools from different laboratories, determination of cutoffs for continuous variables (MFI) and their absolute and relative values, the comparison of the diverse approaches to crossmatch tests and the calculated PRA versus the measured PRA, may lead to interpretation issues for the clinician.

Many of the aspects mentioned above are experiencing changes in terms of interpretation and evaluation. Therefore, we consider that an updated analysis of them is of enormous importance for clinical decision-making.


[sp] En los últimos años han surgido grandes cambios tecnológicos y científicos en las pruebas de laboratorio destinadas a establecer el riesgo y la magnitud del mismo para la aparición de rechazo post-trasplante, al seguimiento de pacientes trasplantados en su evolución o bajo tratamiento anti-rechazo.

El fenómeno zona, la participación del complemento en las pruebas, las diferencias en herramientas de diagnóstico provenientes de distintos laboratorios, establecer los puntos de corte en variables continuas (MFI) y su valor absoluto o relativo, contraponer las distintas formas de aproximarse a la prueba cruzada, el PRA calculado versus el medido generan complejidades de interpretación al clínico.

Muchos de estos aspectos están en proceso de cambio en su interpretación y valoración.

Por ello nos ha parecido de la mayor relevancia una mirada actualizada sobre estos aspectos que nos ayuden en nuestra decisión clínica.


[pt] Nos ultimos anos, observou-se importantes mudanças tecnológicas e científicas em relação aos testes laboratoriais destinados a avaliar o risco de desenvolvimento de rejeição após o transplante, o seguimento dos pacientes transplantados, e, por fim, a eficácia de tratamentos anti-rejeição.

O fenômeno zona, a participação do sistema complemento nos testes, as diferenças entre ferramentas diagnósticas provenientes de distintos laboratórios, além do desafio em se estabelecer pontos de corte a variaveis continuas (MFI) e seus valores absoluto e relativo, da dificuldade de se comparar as diferentes metodologias de "prova cruzada", e da contraposição entre o PRA calculado e o medido geram graus variaveis de complexidade de interpretação para os clínicos.

Muitos desses aspectos estão em processo de revisão de sua interpretação e valorização.

Sendo assim, nos parece da maior relevância uma abordagem atualizada desses temas, para que nos auxiliem na tomada de decisões clínicas.

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