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PROTECT-CHILD Pediatric Transplant Data Implementation Guide
0.1.0-ci-build -

PROTECT-CHILD Pediatric Transplant Data Implementation Guide
0.1.0-ci-build - ci-build

PROTECT-CHILD Pediatric Transplant Data Implementation Guide, published by Protect Child. This guide is not an authorized publication; it is the continuous build for version 0.1.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/protect-child/ and changes regularly. See the Directory of published versions

Immunological Data

One immunological_data row becomes one report plus one biopsy One immunological_data row four clinical acts on one line — different specimens, dates and performers ImmunologicalDataReport groups the results below; carries immunological_data_id blood_group rh_factor 1 per result BloodGroupObservation ABO and Rh, recipient or donor hla_a_1 hla_a_2 hla_b_1 hla_b_2 hla_c_1 hla_c_2 hla_drb1_1 hla_drb1_2 hla_dp_1 hla_dp_2 hla_dqb1_1 hla_dqb1_2 1 per allele HlaTyping LOINC per locus; resolution is in the code. Not a fixed pair of slots: alleles are unordered, and DRB3/4/5 can be 0, 1 or 2. anti_hla_antibodies pre_transplant_anti_hla_dsa 1 per screen AntiHlaAntibodyScreen Negative is a result, not an absent record post_transplant_ab_anti_hla_dsa_class mfi antibody_type 1 per antibody AntiHlaAntibody Target specificity is the value; MFI band required, measured MFI optional anca 1 per test AncaObservation Moves to the lab profile once it accepts coded results banff_category ihc_if_c4d if c4d 1 per biopsy GraftBiopsy A pathology report: its own specimen, date and performer. Same immunological_data_id. ↳ BanffAssessment ↳ C4dStain ↳ LiverRejectionActivityIndex

One DMv1.2 immunological_data row holds four clinical acts, each with its own specimen, date and performer: blood typing, HLA typing, antibody testing and a biopsy read. It becomes an ImmunologicalDataReport (DiagnosticReport, derived from DiagnosticReport (EU core)) with one Observation per result, plus a GraftBiopsy for the histopathology (see Graft biopsy). Both carry the row's immunological_data_id, so it can be reassembled.

Machine-readable crosswalk: ConceptMap DmImmunologicalDataToFhir.

Concept map: ImmunologicalDataLmToFhir

Cardinality key — M = Mandatory (1..1) · R = Recommended (0..1) · O = Optional (0..1)

Report

DM field Card. FHIR path Notes
immunological_data_id M ImmunologicalDataReport.identifier.value The same value is carried on the GraftBiopsy built from the biopsy columns of the same row
visit_id M ImmunologicalDataReport.encounter Reference(Visit); the recipient's Visit, also for donor-side typing
donor_id O ImmunologicalDataReport.subject Reference(Donor) for donor-side typing; recipient results use Reference(PatientTransplant). Donor typing is never filed under the recipient.

Results

DM field Card. Profile Code Value Notes
blood_group R BloodGroupObservation LOINC 883-9 PatientABOGroupVS  
rh_factor R BloodGroupObservation LOINC 10331-7 PatientRhFactorVS  
hla_a_1, hla_a_2 R HlaTyping LOINC 13298-5 / 57290-9 / 78014-8 valueString One Observation per allele
hla_b_1, hla_b_2 R HlaTyping LOINC 13299-3 / 57291-7 / 78015-5 valueString  
hla_c_1, hla_c_2 R HlaTyping LOINC 13302-5 / 77636-9 / 96636-6 valueString  
hla_drb1_1, hla_drb1_2 R HlaTyping LOINC 57298-2 / 57293-3 / 96664-8 valueString  
hla_dp_1, hla_dp_2 R HlaTyping LOINC 12285-3 valueString The DM values are DPB1 alleles; new data SHOULD use 59017-4 or 96648-1
hla_dqb1_1, hla_dqb1_2 R HlaTyping LOINC 53938-7 / 57299-0 / 78017-1 valueString  
anti_hla_antibodies O AntiHlaAntibodyScreen LOINC 44534-6 Positive / Negative  
pre_transplant_anti_hla_dsa R AntiHlaAntibodyScreen LOINC 107913-6 Positive / Negative, free text in note DMv1.2 sheet: pre_trasnplant_anti_hla_dsa
antibody_type R AntiHlaAntibody LOINC 107914-4 (DSA) or 98006-0 valueString — the target HLA specificity One Observation per antibody
post_transplant_ab_anti_hla_dsa_class R AntiHlaAntibody ImmDataComponentCS#hla-class DSAClassVS component[hla_class]
mfi R AntiHlaAntibody ImmDataComponentCS#mfi-category MFICategoryVS component[mfi_category]; the measured MFI is optional, in component[mfi_value] as {MFI}
anca R AncaObservation LOINC 17351-8 Positive / Negative  

Graft biopsy

The histopathology columns become a GraftBiopsy (DiagnosticReport, derived from DiagnosticReport (EU core)), sharing immunological_data_id with the ImmunologicalDataReport from the same row.

DM field Card. FHIR path Value Notes
immunological_data_id M GraftBiopsy.identifier.value   Shared with the ImmunologicalDataReport from the same row
visit_id M GraftBiopsy.encounter   Reference(Visit)
banff_category R BanffAssessment.valueCodeableConcept BanffCategoryVS Categories 1–6
— O BanffAssessment.component integer 0–3 Banff lesion scores: g, ptc, i, t, v, ci, ct, cg, ah, mm
ihc_if_c4d R C4dStain.valueCodeableConcept BanffC4dScoreVS false → c4d-0; true → c4d-1…c4d-3
c4d R C4dStain.note free text  
if R GraftBiopsy.conclusion free text The immunofluorescence narrative
— O LiverRejectionActivityIndex.valueInteger integer 0–9 Banff RAI, with its three constituent 0–3 scores as components
— O GraftBiopsy.specimen   Specimen.collection.bodySite names the grafted organ