ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Impact of Eplet Mismatches on the Risk of Graft Loss: Not All Eplets are Created Equal

H. Mohammadhassanzadeh1, W. Klement2, H. Gebel3, B. Foster4, P. Keown5, K. Oualkacha6, R. Sapir-Pichhadze1

1Medicine, McGill University, Montreal, QC, Canada, 2Organ Donation and Transplantation, Canadian Blood Services, Ottawa, ON, Canada, 3Emory University Hospital, Atlanta, GA, 4Montreal Children's Hospital, Montreal, QC, Canada, 5Medicine, University of British Columbia, Vancouver, BC, Canada, 6Université du Québec À Montréal, Montreal, QC, Canada

Meeting: 2020 American Transplant Congress

Abstract number: 620

Keywords: Epitopes, Graft failure, Immunogenicity, Kidney transplantation

Session Information

Session Name: Biomarkers, Immune Assessment and Clinical Outcomes VI

Session Type: Oral Abstract Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:45pm

 Presentation Time: 3:51pm-4:03pm

Location: Virtual

*Purpose: To mitigate risks related to HLA incompatibility, we assessed whether some unique sequence defined HLA targets (eplets) are associated with graft failure while others are not. We further assessed whether higher risk eplets are differentially distributed within donor and candidate pools.

*Methods: To assess risk of death-censored graft failure associated with individual eplet mismatches, we fit multivariable Cox proportional hazards models in a cohort of 118 382 unsensitized (PRA 0%) US first kidney transplant recipients (2000 to 2015) from the scientific registry of transplant recipients. Allele-level HLA genotypes (A, B, C, DRB1 and DQB1) were imputed using an algorithm from the National Marrow Donor Program. HLA genotypes were translated to epitypes with 449 potential eplets (223 Class I: 72 antibody-verified (AbVer), 151 non-antibody-verified (non-AbVer), 226 Class II: 72 AbVer, 154 Non-AbVer) considered. Models were adjusted for recipient, donor and transplant characteristics. Hazard ratio (HR) estimates with false discovery corrected p-value threshold < 0.0001 were deemed statistically significant. Eplet distributions in donor (N=241 738) and candidate (N= 140 911) pools were also measured.

*Results: Of 449 eplets, a total of 410 eplet mismatches were observed; of those 154 (75 class I: 30 AbVer and 45 non-AbVer, and 79 class II: 33 AbVer and 46 non-AbVer) were statistically significantly associated with an increased risk of death-censored graft failure. Eplet distributions in donor and candidate pools did not differentially inform eplet mismatches associated with death-censored graft failure versus not. Figure 1 presents selected HLA-DQB1 eplet mismatches associated with graft loss and their distributions in donor and recipient pools.

*Conclusions: Our analysis identified a subset of AbVer and non-AbVer HLA class I and II eplet mismatches associated with increased risk of graft loss. These findings set the stage for understanding determinants of immune dominant mismatches. A strategy prioritizing higher risk eplets could enhance feasibility and improve utility of donor:recipient eplet matching.

 border=

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Mohammadhassanzadeh H, Klement W, Gebel H, Foster B, Keown P, Oualkacha K, Sapir-Pichhadze R. Impact of Eplet Mismatches on the Risk of Graft Loss: Not All Eplets are Created Equal [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-eplet-mismatches-on-the-risk-of-graft-loss-not-all-eplets-are-created-equal/. Accessed May 9, 2025.

« Back to 2020 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences