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

Which is More Important for Predicting De Novo DSA Production, B Cell Epitope (EPLET) or T Cell Epitope (PIRCHE) Analysis ?

T. Kobayashi1, T. Tomosugi2, S. Sakamoto2, S. Ashimine1, K. Iwasaki1, M. Niemann3, E. Spierings4, Y. Miwa1, M. Okumura1, K. Ishiyama1, A. Takeda2, N. Goto2, S. Narumi2, Y. Watarai2

1Aichi Medical University School of Medicine, Nagakute, Japan, 2Nagoya Daini Red Cross Hospital, Nagoya, Japan, 3PIRCHE AG, Berlin, Germany, 4UMC Utrecht, Utrecht, Netherlands

Meeting: 2022 American Transplant Congress

Abstract number: 120

Keywords: Epitopes, Histocompatibility, HLA antibodies, Kidney transplantation

Topic: Clinical Science » Kidney » 45 - Kidney Chronic Antibody Mediated Rejection

Session Information

Session Name: Kidney Complications: Chronic Antibody Mediated Rejection & Immune Mediated Late Graft Failure

Session Type: Rapid Fire Oral Abstract

Date: Sunday, June 5, 2022

Session Time: 5:30pm-7:00pm

 Presentation Time: 6:40pm-6:50pm

Location: Hynes Room 302

*Purpose: De novo donor-specific antibodies (dnDSA) can cause chronic ABMR, resulting in poor prognosis. Recently, mismatch at B cell epitope level, i.e. EPLET mismatch, has been reported to be associated with dnDSA production. Similar results have also been demonstrated for T cell epitope matching, i.e. PIRCHE score. In the study of kidney transplant recipients with non-donor specific HLA antibodies, shared T cell epitope-positive patients showed early dnDSA production and death censored graft failure. Such donor reactive memory T cells could be estimated by PIRCHE. We investigated whether the significance of EPLET and PIRCHE analysis differs depending on the presence or absence of donor-specific sensitization history.

*Methods: Subgroup analysis of the previous study was performed. 691 living donor kidney transplants without preformed DSA between 2008 and 2015 were divided into two groups, (A) recipients with prior pregnancy, receiving a kidney from husband or child and (B) recipients with no prior donor-specific immunization. Only Class II dnDSA (DR and DQ) were considered. EPLET mismatches and PIRCHE scores were determined by HLAMatchmaker ver 3.1 (antibody-verified, DRB and DQB) and PIRCHE web service, respectively.

*Results: Twelve and 88 developed dnDSA in (A) potentially sensitized patients (n=112) and (B) unsensitized patients (n=579), respectively. EPLET mismatches of dnDSA (+) and dnDSA (-) were 9.3±4.3 vs 7.4±3.7 (p=0.2358) and 7.9±3.3 vs 5.2±4.1 (p<0.001) in (A) and (B) group, respectively. PIRCHE scores of dnDSA (+) and dnDSA (-) were 391±179 vs 268±138 (p=0.0135), 248±124 vs 193±135 (p<0.001) in (A) and (B), respectively. Univariate analysis revealed a significant difference in EPLET mismatch, PIRCHE score and acute T cell mediated rejection between dnDSA(+) and dnDSA(-). Multivariate analysis showed dnDSA was significantly associated with PIRCHE score in (A), whereas EPLET mismatch was more significant in (B) (Table 1).

*Conclusions: EPLET mismatch and PIRCHE score were effective in predicting dnDSA production particularly in patients without and with sensitization history of donor HLA, respectively. This suggests that B cell epitopes are related to primary response, whereas T cell epitopes are associated with memory response more closely, after kidney transplantation.

Risk factors associated with de novo DSA (Cox Proportional Hazards Regression Model: Multivariate)
(A) Potentially sensitized (n=112) (B) Unsensitized (n=579)
EPLET mismatch (DRB+DQB) 1.094(0.910-1.325)  p=0.3389 1.096(1.035-1.157) p=0.0020
In(PIRCHE score+1)

4.098(1.055-19.029) p=0.0409 1.442(1.048-2.086) p=0.0224
Acute T cell mediated rejection 7.189(1.513-27.364) p=0.0167 2.197(1.241-3.675) p=0.0082
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

To cite this abstract in AMA style:

Kobayashi T, Tomosugi T, Sakamoto S, Ashimine S, Iwasaki K, Niemann M, Spierings E, Miwa Y, Okumura M, Ishiyama K, Takeda A, Goto N, Narumi S, Watarai Y. Which is More Important for Predicting De Novo DSA Production, B Cell Epitope (EPLET) or T Cell Epitope (PIRCHE) Analysis ? [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/which-is-more-important-for-predicting-de-novo-dsa-production-b-cell-epitope-eplet-or-t-cell-epitope-pirche-analysis/. Accessed May 25, 2025.

« Back to 2022 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