Eplet Mismatch Load and De Novo Occurrence of Donor-Specific Anti-HLA Antibodies, Rejection, and Graft Failure after Kidney Transplantation: An Observational Cohort Study.
Aleksandar SenevMaarten CoemansEvelyne LerutVicky Van SandtJohan KerkhofsLiesbeth DaniëlsMarleen Vanden DriesscheVeerle CompernolleBen SprangersElisabet Van LoonJasper CallemeynFrans ClaasAnat R TamburGeert VerbekeDirk KuypersMarie-Paule EmondsMaarten NaesensPublished in: Journal of the American Society of Nephrology : JASN (2020)
Eplet mismatches in HLA-DQ confer substantial risk for de novo DSA formation, graft rejection, and graft failure after kidney transplantation. Mismatches in other loci seem to have less effect. The results suggest that antibody-verified HLA-DQ eplet mismatch load could be used to guide personalized post-transplant immunosuppression. Adoption of molecular matching for DQA1 and DQB1 alleles could also help to minimize de novo DSA formation and potentially improve transplant outcomes.