ArticleHLA2025
Comparison Between Antigen and Allelic HLA Mismatches, and the Risk of Acute Rejection in Kidney Transplant Recipients.
Article in HLA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- The role of eplet matching in solid organ transplantation.Frontiers in transplantation · 2025Review
- Living Donation and Pre-Emptive Transplantation Are More Important Than HLA Matching in Pediatric Kidney Transplantation: Results From a 33-Year Comparative OPTN Study.Transplant international : official journal of the European Society for Organ Transplantation · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Deceased donor kidney allocation relies on HLA compatibility at the antigen level, as optimal matching reduces the risk of acute rejection. Whether HLA allele-level mismatches improve, the prediction of acute rejection after transplantation remains unclear. Using data from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) from 2017 to 2020, HLA antigenic and allelic mismatches between recipients and deceased donors were calculated with imputation of two-field allelic equivalents undertaken where required. The discordance between antigen and allele mismatches was calculated, and oblique random survival forest models were used to predict acute rejection. Predictive performance of antigen (HLA-A, -B, -DRB1 and -DQB1), allele (HLA-A, -B, -DRB1 and -DQB1) and extended allele (HLA-A, -B, -C, -DRB1, -DQA1 and -DQB1) models was examined using concordance index and integrated Brier scores, with variable importance calculated using permutation-based methods. Among 2644 recipients followed for a median of 1.7 years, 521 recipients (20%) experienced acute rejection. Discordant numbers of antigenic and allelic mismatches occurred in 8%, 9%, 24% and 17% of HLA-A, -B, -DRB1 and -DQB1 loci, respectively. Predictive performances were similar across all models, with concordance indices of 0.62-0.63 and integrated Brier scores of 0.09. HLA-DRB1 and -DQB1 mismatches were the strongest predictors of acute rejection across models. In patients matched at the HLA-DRB1 or -DQB1 antigen, those with allelic mismatches had similar incidences of rejection compared to those without. Allelic-level assessment of HLA compatibility did not improve the prediction of acute rejection and may disadvantage certain recipients by reclassifying them into higher mismatch categories in allocation algorithms without providing clear clinical benefit.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.