Establishment of an HLA laboratory in Madagascar: Technical and economic difficulties in developing country

Background: Chronic renal failure is a worldwidepublic health issue. In Madagascar, this condition of heavy care is a medical challenge in a low-income country. In 2016, an estimated 8,000 - 10,000 people with kidney failure and only 1.26% have access to hemodialysis. About 30 patients were able to...

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Main Authors: Toky Rakotomalala Randriamahazo, Eliane Mikkelsen Ranivoharisoa, Elodie Emile Batavisoaniatsy, Aimée Olivat Rakoto Alson, Lova Narindra Randriamanantsoa, Andry Rasamindrakotroka
Format: Article
Language:English
Published: Elsevier 2019-06-01
Series:Transplantation Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S2451959619300071
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author Toky Rakotomalala Randriamahazo
Eliane Mikkelsen Ranivoharisoa
Elodie Emile Batavisoaniatsy
Aimée Olivat Rakoto Alson
Lova Narindra Randriamanantsoa
Andry Rasamindrakotroka
author_facet Toky Rakotomalala Randriamahazo
Eliane Mikkelsen Ranivoharisoa
Elodie Emile Batavisoaniatsy
Aimée Olivat Rakoto Alson
Lova Narindra Randriamanantsoa
Andry Rasamindrakotroka
author_sort Toky Rakotomalala Randriamahazo
collection DOAJ
description Background: Chronic renal failure is a worldwidepublic health issue. In Madagascar, this condition of heavy care is a medical challenge in a low-income country. In 2016, an estimated 8,000 - 10,000 people with kidney failure and only 1.26% have access to hemodialysis. About 30 patients were able to access live organ transplantation abroad.Our objectives are to set up an HLA histocompatibility laboratory providing HLA typing, search for anti-HLA antibodies, and crossmatch. Evaluate the available structures of the Immunology laboratory. Look for partner laboratories for more specialized research. Materials and methods: The Joseph Ravoahangy Andrianavalona University Hospital Immunology Laboratory is equipped with a conventional PCR and real-time PCR platform, an ELISA immunoassay platform, and inverted fluorescence microscope. Results: The techniques to be implemented in Madagascar for the HLA Laboratory are the HLA typing of the donor and the recipient by the PCRSSP and microlymphocytotoxicity (LCT) technique. The search for anti-HLA antibodies will be done by ELISA and LCT and crossmatch in LCT.We have created cooperation with the Réunion France histocompatibility laboratory for the identification of recipient and donor HLA antibodies and crossmatch by Luminex. Conclusion: The presence of HLA platform in Madagascar will allow preparing the establishment of a future kidney transplant in the country but also for improved management of patients waiting on abroad transplant list in regards of donor selection and post-transplant monitoring. Keywords: Kidney transplant, HLA laboratory, Developing country, Madagascar
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spelling doaj.art-91c8cb3a79e346d7aadab334d19f1abe2022-12-21T17:32:40ZengElsevierTransplantation Reports2451-95962019-06-0142Establishment of an HLA laboratory in Madagascar: Technical and economic difficulties in developing countryToky Rakotomalala Randriamahazo0Eliane Mikkelsen Ranivoharisoa1Elodie Emile Batavisoaniatsy2Aimée Olivat Rakoto Alson3Lova Narindra Randriamanantsoa4Andry Rasamindrakotroka5Immunology Laboratory of Joseph Ravoahangy University Hospital Center Andrianavalona, MadagascarNephrology Department of Joseph Ravoahangy University Hospital Center Andrianavalona, MadagascarImmunology Laboratory of Joseph Ravoahangy University Hospital Center Andrianavalona, MadagascarImmunology Laboratory of Joseph Ravoahangy University Hospital Center Andrianavalona, MadagascarNephrology Department of Joseph Ravoahangy University Hospital Center Andrianavalona, MadagascarImmunology Laboratory of Joseph Ravoahangy University Hospital Center Andrianavalona, MadagascarBackground: Chronic renal failure is a worldwidepublic health issue. In Madagascar, this condition of heavy care is a medical challenge in a low-income country. In 2016, an estimated 8,000 - 10,000 people with kidney failure and only 1.26% have access to hemodialysis. About 30 patients were able to access live organ transplantation abroad.Our objectives are to set up an HLA histocompatibility laboratory providing HLA typing, search for anti-HLA antibodies, and crossmatch. Evaluate the available structures of the Immunology laboratory. Look for partner laboratories for more specialized research. Materials and methods: The Joseph Ravoahangy Andrianavalona University Hospital Immunology Laboratory is equipped with a conventional PCR and real-time PCR platform, an ELISA immunoassay platform, and inverted fluorescence microscope. Results: The techniques to be implemented in Madagascar for the HLA Laboratory are the HLA typing of the donor and the recipient by the PCRSSP and microlymphocytotoxicity (LCT) technique. The search for anti-HLA antibodies will be done by ELISA and LCT and crossmatch in LCT.We have created cooperation with the Réunion France histocompatibility laboratory for the identification of recipient and donor HLA antibodies and crossmatch by Luminex. Conclusion: The presence of HLA platform in Madagascar will allow preparing the establishment of a future kidney transplant in the country but also for improved management of patients waiting on abroad transplant list in regards of donor selection and post-transplant monitoring. Keywords: Kidney transplant, HLA laboratory, Developing country, Madagascarhttp://www.sciencedirect.com/science/article/pii/S2451959619300071
spellingShingle Toky Rakotomalala Randriamahazo
Eliane Mikkelsen Ranivoharisoa
Elodie Emile Batavisoaniatsy
Aimée Olivat Rakoto Alson
Lova Narindra Randriamanantsoa
Andry Rasamindrakotroka
Establishment of an HLA laboratory in Madagascar: Technical and economic difficulties in developing country
Transplantation Reports
title Establishment of an HLA laboratory in Madagascar: Technical and economic difficulties in developing country
title_full Establishment of an HLA laboratory in Madagascar: Technical and economic difficulties in developing country
title_fullStr Establishment of an HLA laboratory in Madagascar: Technical and economic difficulties in developing country
title_full_unstemmed Establishment of an HLA laboratory in Madagascar: Technical and economic difficulties in developing country
title_short Establishment of an HLA laboratory in Madagascar: Technical and economic difficulties in developing country
title_sort establishment of an hla laboratory in madagascar technical and economic difficulties in developing country
url http://www.sciencedirect.com/science/article/pii/S2451959619300071
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