HLA matching for three HLA loci (HLA-A, HLA-B, and HLA-DR) at a low-resolution antigen level has been integral to algorithms for allocating donor kidneys for transplant since the 1970s. The authors used high-resolution genotyping of the 11 HLA loci and analysis of mismatches of HLA eplets—small patches of surface-exposed amino acids of the HLA molecule—to evaluate the effect of eplet mismatches on de novo formation of donor-specific HLA antibodies (DSAs) and kidney transplant outcome.
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