Future Cardiac Allograft Vasculopathy in Heart Transplant Recipients is Predicted by Class II Human Leukocyte Antigen Eplet Mismatch Score

Walton, D.C.; Hiho, Steven; Kovacs, Attila; Hobson, Jamie; Henriksen, A.; Kaye, D.; Hare, James L.

doi:10.1016/j.hlc.2018.06.136

Cited by 2 publications

(2 citation statements)

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“…16 This could be because in our study, the class-II Ep MM only include DRB1+DQA/B. Although several groups have demonstrated the independent role of Ep MM load in chronic rejection after solid organ transplantation, 30-34 there is no consensus about the amount of Ep MM to establish the risk of CLAD development.…”

Section: Discussionmentioning

confidence: 80%

DQA1 Eplet Mismatch Load As an Independent Risk Factor of CLAD After Lung Transplantation

González-López

Cuesta

Roa-Bautista

et al. 2023

Transplantation Direct

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Background. Lung transplantation remains the treatment of choice for end-stage lung diseases, and recipient selection is currently based on clinical urgency, ABO compatibility, and donor size. The risk of allosensitization is classically based on HLA mismatch, but eplet mismatch load is increasingly seen to be important in long-term outcomes in solid organ transplantation. Chronic lung allograft dysfunction (CLAD) is relatively common and relevant, affecting almost 50% of patients 5 y after transplantation and being the first cause of death from the first year after transplantation. The overall class-II eplet mismatch load has been associated with CLAD development. Methods. Based on clinical data, 240 lung transplant recipients were eligible for CLAD, and HLA and eplet mismatch was analyzed using the HLAMatchmaker 3.1 software. Results. A total of 92 (38.3%) lung transplant recipients developed CLAD. The time free-of-CLAD was significantly decreased in patients with presence of DQA1 eplet mismatches (P = 0.015). Furthermore, when other previously described CLAD risk factors were studied in a multivariate analysis, the presence of DQA1 eplet mismatches was found to be independently associated with the early onset of CLAD. Conclusions. The concept of epitope load has arisen as a new tool to better define donor–recipient immunologic compatibility. The presence of DQA1 eplet mismatches potentially would increase the likelihood of developing CLAD.

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Section: Discussionmentioning

confidence: 80%

DQA1 Eplet Mismatch Load As an Independent Risk Factor of CLAD After Lung Transplantation

González-López

Cuesta

Roa-Bautista

et al. 2023

Transplantation Direct

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“…2,7 HLAMatchmaker is a computational program based on modeling of HLA crystal structures that compares sequences of HLA alleles and defines eplet mismatches (epMMs) between the recipient and donor. [8][9][10][11] Structural similarity between a recipient and donor, as defined by a low epMM score, is associated with better outcomes in kidney, 12,13 heart, 14,15 and LTx. 6,16 Previous LTx studies, albeit not at molecular level, have demonstrated that HLA compatibility decreases the risk of CLAD [17][18][19] and dnDSA development 5,6,20 ; however, studies showing improved survival are limited.…”

Section: Introductionmentioning

confidence: 99%

Determining Clinical Thresholds for Donor HLA Eplet Compatibility to Predict Best Outcomes Following Lung Transplantation

Hiho

Walton

Paraskeva

et al. 2022

Transplantation Direct

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Background. Currently, the assessment of immunological risk in lung transplantation (LTx) does not completely consider HLA compatibility at the molecular level. We have previously demonstrated the association of HLA eplets in predicting chronic lung allograft dysfunction following LTx; however, the associations between HLA eplet mismatch (epMM) loads and overall survival are unknown. Methods. In this retrospective, single-center study, 277 LTx donor-recipient pairs were high resolution HLA typed and analyzed for HLA epMMs using HLAMatchmaker (version 3.1). LTx pairs were also assessed for the presence of the previously described risk epitope mismatches DQ2-DQA1*05 and DQ7-DQA1*05. Results. HLA class I epMMs were not associated with deleterious outcomes; however, lower HLA class II (≤19), DQA1 (≤2), and combined HLA class I and II (≤29) epMM demonstrated an association with increased time to chronic lung allograft dysfunction and improved overall survival. The presence of a risk epitope mismatch was not associated with worse clinical outcomes. Conclusions. HLA epMM can risk-stratify LTx recipients and potentially guide donor-recipient matching and immunosuppression strategies.

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Future Cardiac Allograft Vasculopathy in Heart Transplant Recipients is Predicted by Class II Human Leukocyte Antigen Eplet Mismatch Score

Cited by 2 publications

References 0 publications

DQA1 Eplet Mismatch Load As an Independent Risk Factor of CLAD After Lung Transplantation

DQA1 Eplet Mismatch Load As an Independent Risk Factor of CLAD After Lung Transplantation

Determining Clinical Thresholds for Donor HLA Eplet Compatibility to Predict Best Outcomes Following Lung Transplantation

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