Cross-organ hierarchy of HLA molecular mismatches in donor-specific antibody development in solid organ transplantations.

ABSTRACT: Donor-specific antibodies (DSAs) against human leukocyte antigen (HLA) play a crucial role in antibody-mediated rejection, a major barrier to successful organ transplantation. Donor-recipient HLA molecular incompatibility critically influences DSA susceptibility, commonly assessed by analyzing mismatches in the HLA eplet repertoire. This study, including six distinct liver, lung, and kidney transplant cohorts from two centers (978 donor-recipient pairs), explores associations between individual eplet mismatches and DSA development. Certain mismatched eplets are strongly linked to DSA development, while others show weaker associations, a trend consistent across different organ types. Machine learning leverages these hierarchical associations to develop an eplet risk score (ERS), outperformi

SUBMITTER: Hirata M 

PROVIDER: S-EPMC12208338 | biostudies-literature | 2025 Jun

REPOSITORIES: biostudies-literature