Class II HLA Epitope Matching—A Strategy to Minimize De Novo Donor-Specific Antibody Development and Improve Outcomes
Although testing for HLA antibodies is long-established practice in transplantation, the immune system actually makes antibodies against specific epitopes, not antigens. This study used the HLA Matchmaker program to assess whether the degree of epitope mismatching predicted the development of post-transplant class II donor-specific antibodies. Thresholds for epitope mismatching at DR and DQ were found. This strategy, if validated, would result in a change in allocation practices, but could lead to better long-term outcomes post-transplant.