“…However, simple enumeration of differences at the whole Ag level is constrained by limited possible values (zero, one, or two mismatches per locus) and does not account for differences in donor HLA immunogenicity for a given recipient. Current approaches for determining the potential of a donor HLA to induce an alloantibody response are based on quantifying the degree of dissimilarity between the donor and recipient HLA molecules ( 12 , 17 , 19 , 21 , 65 ). The most frequently used methods (HLAMatchmaker and Cambridge HLA immunogenicity algorithm) evaluate differences in the number and location of amino acid mismatches at continuous and discontinuous (eplets) positions on the HLA sequence, and multiple studies have suggested they provide superior risk stratification over conventional HLA mismatch grade for predicting development of DSA, allograft rejection, transplant glomerulopathy, and allograft survival ( 14 , 16 , 18 , 20 , 63 ).…”