Acceptable mismatching at the class II epitope level: the Canadian experience

作者：Wiebe Chris; Nickerson Peter^*

来源：Current Opinion in Organ Transplantation, 2014, 19(4): 442-446.

DOI：10.1097/MOT.0000000000000104

• antibody-mediated rejection
• donor-specific antibody
• epitope
• kidney transplantation
• transplant rejection

Purpose of review %26lt;br%26gt;To summarize the evidence concerning human leukocyte antigen (HLA) epitope mismatch analysis as a means to predict donor-specific antibody (DSA) development and allograft survival. %26lt;br%26gt;Recent findings %26lt;br%26gt;HLA epitope mismatch analysis outperforms traditional whole molecule antigen mismatch for predicting the risk of de-novo DSA development. By analyzing the number of epitope mismatches for a given donor-recipient pair, thresholds have been identified to stratify patients into those at high or low risk of de-novo DSA development. Epitope specificity assignment in patients who develop de-novo DSA compared with controls who do not provides an opportunity to study the relative immunogenicity of mismatched HLA epitopes. %26lt;br%26gt;Summary %26lt;br%26gt;Recognizing that de-novo DSA is a major cause of graft loss, HLA epitope mismatch analysis is a strategy to minimize de-novo DSA development and improve long-term graft survival.

• 出版日期2014-8