ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2021
Adequate tacrolimus exposure modulates the impact of HLA class II molecular mismatch: a validation study in an American cohort.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed, 51 citations in OpenAlex.
- From thresholds to trajectories: a perspective on reframing alloimmune risk for computational modeling in solid organ transplantation.Frontiers in immunology · 2026Review
- Clinical application of PIRCHE scores: reclassifying immunologic risk in patients with medium eplet mismatch.Frontiers in immunology · 2026Article
- Conference Report-The Past, Current, and Future Challenges in Transplantation: A Festschrift in Honor of Professor Paul Anthony Keown.Canadian journal of kidney health and disease · 2026Article
- Immunosuppression Efficacy via Nonlinear Modeling and Probabilistic Analysis of Human Leukocyte Antigen Match and Dose Effects on Allograft Rejection Risk.Immunity, inflammation and disease · 2025Article
- Eplet mismatch analysis in kidney transplantation: from concept to clinical practice.Clinical transplantation and research · 2025Review
- Anti-Human Leukocyte Antigen Antibody Detection from Terasaki's Humoral Theory to Delisting Strategies in 2024.International journal of molecular sciences · 2025Review
- The role of eplet matching in solid organ transplantation.Frontiers in transplantation · 2025Review
- Article
- HLA Genotype Imputation Results in Largely Accurate Epitope Mismatch Risk Categorization Across Racial Groups.Transplantation direct · 2024Article
- HLA-DR/DQ eplet mismatch predictsFrontiers in genetics · 2024Article
- Improving long-term kidney allograft survival by rethinking HLA compatibility: from molecular matching to non-HLA genes.Frontiers in genetics · 2024Review
- New Human Leukocyte Antigen (HLA) Antibody Formation and Creatinine Elevation With Abaloparatide in Kidney Transplant Recipient.JBMR plus · 2023Article
- Preventing Rejection of the Kidney Transplant.Journal of clinical medicine · 2023Review
- The Clinical Utility of Post-Transplant Monitoring of Donor-Specific Antibodies in Stable Renal Transplant Recipients: A Consensus Report With Guideline Statements for Clinical Practice.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
- The negative impact of T cell-mediated rejection on renal allograft survival in the modern era.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2022Observational
- Progress in kidney transplantation: The role for systems immunology.Frontiers in medicine · 2022Review
- HLA-DQ-Specific Recombinant Human Monoclonal Antibodies Allow for In-Depth Analysis of HLA-DQ Epitopes.Frontiers in immunology · 2021Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Clinicians have few tools to predict the risk of alloimmune injury that would guide immunosuppression management in renal transplant patients. We evaluated human leukocyte antigen (HLA)-DR/DQ molecular mismatch to predict de novo donor-specific antibodies (DSAs) during the first year of transplant and explored how differences in tacrolimus exposure may modulate this risk. HLA-DR and -DQ eplet mismatches were determined between 444 donor-recipient pairs in Denver, Colorado between 2007 and 2013. Previously defined mismatch thresholds stratified recipients into low- (N = 119), intermediate- (N = 153), and high- (N = 172) risk categories. The area under the curve for DSA at 1 year was 0.84 and 0.82 for HLA-DR and HLA-DQ eplet mismatches, respectively. Compared to low-risk patients, there was a graded increase in risk of DR/DQ DSA in intermediate (HR 15.39, 95% CI 2.01-118.09, p = .009) and high-risk (HR 23.81, 95% CI 3.17-178.66, p = 0.002) categories. Intermediate- and high-risk patients with a mean tacrolimus <6 ng/ml versus >8 ng/ml had increased risk of DR/DQ DSA at 1 year (HR 2.34, 95% CI 1.05-5.22, p = .04). HLA molecular mismatch represents a reproducible, objective, and clinically relevant tool to stratify patients by alloimmune risk and may help guide personalized immunosuppression management.
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