Observational studyFrontiers in immunology2026
Association of PIRCHE scores and allograft injury in kidney transplant recipients.
Observational study in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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
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Who cites it
1 citing paper in PubMed.
- Clinical application of PIRCHE scores: reclassifying immunologic risk in patients with medium eplet mismatch.Frontiers in immunology · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Early allograft injury during the first year after kidney transplantation is a major determinant of long-term graft survival. Predicted Indirectly ReCognizable HLA Epitopes (PIRCHE) quantify donor-derived human leucocyte antigen (HLA) peptides presented to recipient CD4 Methods: In this single-center retrospective cohort study, we evaluated adult kidney transplant recipients transplanted between 2021 and 2024. Five-locus PIRCHE-T2 (T-cell epitope load) and PIRCHE-B (surface-accessible amino acid mismatch) scores were calculated using high-resolution HLA typing with imputation when necessary. The primary endpoint was a composite of post-transplant allograft injury within one year, including donor-specific antibody (DSA) development, histologic or molecular rejection, or elevation of donor-derived cell-free DNA (dd-cfDNA). Secondary endpoints were each component analyzed separately. Predictive performance was assessed using receiver operating characteristic analysis and compared to the only HLA A/B/DR antigen mismatch model, and associations were evaluated using Cox proportional hazards models. Results: Among 683 recipients, 250 (37%) experienced the primary endpoint. Higher five-locus PIRCHE-T2 and PIRCHE-B scores were significantly associated with the composite outcome [adjusted hazard ratio (HR)(95% confidence interval (CI)] Conclusions: Higher PIRCHE scores are associated with increased risk of early alloimmune injury after kidney transplantation across multiple complementary biomarkers. Although discriminatory performance was modest, PIRCHE provides mechanistically grounded risk stratification and may complement existing immunologic assessment strategies.
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