ArticlePLoS computational biology2021
Computational Eurotransplant kidney allocation simulations demonstrate the feasibility and benefit of T-cell epitope matching.
Article in PLoS computational biology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Novel Allocation Strategies Can Boost Kidney Exchange Programs: A Monte Carlo Simulation.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- A discrete time simulation model for kidney allocation in Germany.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Simulation of prospective PIRCHE-II molecular matching in Canada: a feasibility study.Frontiers in immunology · 2026Article
- Eplet mismatch analysis in kidney transplantation: from concept to clinical practice.Clinical transplantation and research · 2025Review
- The role of eplet matching in solid organ transplantation.Frontiers in transplantation · 2025Review
- The Progress and Challenges of Implementing HLA Molecular Matching in Clinical Practice.Transplant international : official journal of the European Society for Organ Transplantation · 2025Review
- Improving long-term kidney allograft survival by rethinking HLA compatibility: from molecular matching to non-HLA genes.Frontiers in genetics · 2024Review
- PIRCHE-II Risk and Acceptable Mismatch Profile Analysis in Solid Organ Transplantation.Methods in molecular biology (Clifton, N.J.) · 2024Article
- NephroCAGE-German-Canadian Consortium on AI for Improved Kidney Transplantation Outcome: Protocol for an Algorithm Development and Validation Study.JMIR research protocols · 2023Article
- An Integrated Approach Using HLAMatchmaker and Pirche II for Epitopic Matching in Pediatric Kidney Transplant-A Romanian Single-Center Study.Children (Basel, Switzerland) · 2023Article
- Alloimmune Risk Stratification for Kidney Transplant Rejection.Transplant international : official journal of the European Society for Organ Transplantation · 2022Article
- Snowflake epitope matching correlates with child-specific antibodies during pregnancy and donor-specific antibodies after kidney transplantation.Frontiers in immunology · 2022Article
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Authors and funding
4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
The EuroTransplant Kidney Allocation System (ETKAS) aims at allocating organs to patients on the waiting list fairly whilst optimizing HLA match grades. ETKAS currently considers the number of HLA-A, -B, -DR mismatches. Evidently, epitope matching is biologically and clinically more relevant. We here executed ETKAS-based computer simulations to evaluate the impact of epitope matching on allocation and compared the strategies. A virtual population of 400,000 individuals was generated using the National Marrow Donor Program (NMDP) haplotype frequency dataset of 2011. Using this population, a waiting list of 10,400 patients was constructed and maintained during simulation, matching the 2015 Eurotransplant Annual Report characteristics. Unacceptable antigens were assigned randomly relative to their frequency using HLAMatchmaker. Over 22,600 kidneys were allocated in 10 years in triplicate using Markov Chain Monte Carlo simulations on 32-CPU-core cloud-computing instances. T-cell epitopes were calculated using the www.pirche.com portal. Waiting list effects were evaluated against ETKAS for five epitope matching scenarios. Baseline simulations of ETKAS slightly overestimated reported average HLA match grades. The best balanced scenario maintained prioritisation of HLA A-B-DR fully matched donors while replacing the HLA match grade by PIRCHE-II score and exchanging the HLA mismatch probability (MMP) by epitope MMP. This setup showed no considerable impact on kidney exchange rates and waiting time. PIRCHE-II scores improved, whereas the average HLA match grade diminishes slightly, yet leading to an improved estimated graft survival. We conclude that epitope-based matching in deceased donor kidney allocation is feasible while maintaining equal balances on the waiting list.
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