An integrative algorithm combining HLA epitope registry, PIRCHE-T2, and PIRCHE-B outcomes to improve immunological risk stratification in kidney transplantation.

ABSTRACT:

Aim

Kidney transplantation remains the most effective treatment for end-stage kidney disease. Still, the development of de novo donor-specific antibodies (dnDSA) increases the risk of rejection and allograft failure. While molecular matching algorithms assess B-cell and T-cell epitope mismatches, no single method fully captures rejection risk across immune pathways. This study combines the HLA Epitope Registry (Epregistry), PIRCHE-T2, and PIRCHE-B scores to enhance risk stratification, allowing for early intervention in high-risk recipients and improving long-term outcomes.

Methods

A retrospective study of 594 kidney transplant recipients in Saskatchewan (1981-2021), Canada, was conducted, tracking de novo donor-specific antibodies (dnDSA) development until Jan

SUBMITTER: Zhao H 

PROVIDER: S-EPMC12855065 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature