Date: Saturday, May 30, 2020
Session Name: Poster Session A: Histocompatibility and Immunogenetics
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: HLA-Epitope mismatch improves risk stratification following kidney transplantation. Based on population data, high resolution HLA types required for epitope prediction can be imputed based on the serotype-level data that is routinely reported by organ procurement organizations. In this analysis we wanted to test if epitope mismatch calculated by the HLAmatchmaker using only serotype-level HLA data for HLA-A,-B and -DR is able to risk stratify kidney transplant recipients (KTR) within identical HLA serotype-level mismatch groups.
*Methods: We included a total of 1,638 first time KTR of a deceased donor transplanted at the Medical University of Vienna between 2000 and 2015 who were followed at our outpatient clinic. HLA serotype-level data for HLA-A, -B and -DR were included as reported by Eurotransplant. HLAMatchmaker eplet scores were calculated using HLA -A, -B and -DR serotype information with the imputation method developed by Geneugelijk et al. published in Immunol. Res. in 2017.
*Results: The median HLA serotype and HLA eplet mismatch in our cohort were three and 29, respectively. Univariable Cox-models showed that both HLA serotype and eplet mismatch were statistically significantly associated with graft loss HR: 1.16 (95% CI: 1.06 to 1.26) and HR: 1.01 (95% CI: 1.01 to 1.02). While HLA serotype mismatch and eplet mismatch were highly correlated (pearson: 0.82), eplet mismatch was still significantly associated with the risk of graft loss in the group of KTR with an HLA serotype mismatch of three HR: 1.04 (95% CI: 1.01 to 1.06). Further stratification of this group of patients based on the mean eplet mismatch into two strata of patients with an eplet mismatch below and above 29.9, respectively, showed that KTRs in the high eplet mismatch group had an 85% higher risk for graft loss.
*Conclusions: Eplet mismatch score calculated from HLA-A, -B, and -DR serotype-level data provides further risk stratification on top of the currently used HLA-A, -B, and -DR serotype-level mismatch.
To cite this abstract in AMA style:Heinzel A, Reindl-Schwaighofer R, Kainz A, Hu K, Oberbauer R. Eplet Mismatch Imputed from HLA Serotype-Level Data Can Improve Risk Stratification for Kidney Allograft Loss [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/eplet-mismatch-imputed-from-hla-serotype-level-data-can-improve-risk-stratification-for-kidney-allograft-loss/. Accessed October 24, 2020.
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