De Novo donor-specific anti-HLA antibody risk stratification in kidney transplantation using a combination of B cell and T cell molecular mismatch assessment

IntroductionThe presence of de novo donor-specific antibody (dnDSA) has detrimental effect on allograft outcomes in kidney transplantation. As humoral responses in transplantation are elicited targeting non-self-epitopes on donor HLA proteins, assessing HLA mismatches at the molecular level provides...

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Main Authors: Elaine Chou-Wu, Matthias Niemann, Danny Youngs, Idoia Gimferrer
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1508796/full
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author Elaine Chou-Wu
Matthias Niemann
Danny Youngs
Idoia Gimferrer
author_facet Elaine Chou-Wu
Matthias Niemann
Danny Youngs
Idoia Gimferrer
author_sort Elaine Chou-Wu
collection DOAJ
description IntroductionThe presence of de novo donor-specific antibody (dnDSA) has detrimental effect on allograft outcomes in kidney transplantation. As humoral responses in transplantation are elicited targeting non-self-epitopes on donor HLA proteins, assessing HLA mismatches at the molecular level provides a refined means for immunological risk stratification.MethodsIn the present study, we utilized three HLA molecular mismatch assessment algorithms, Snow, HLAMatchmaker, and PIRCHE-II, to evaluate the independent and synergistic association of B cell and T cell epitope mismatches with dnDSA development in a cohort of 843 kidney transplant recipients.ResultsOur results demonstrated that B cell and T cell epitope mismatches at HLA Class I and DRB1/DQB1 loci are remarkably increased in dnDSA-positive recipients, even after normalization by allele mismatch numbers in individual study subjects. Furthermore, elevated Snow, verified eplet mismatches, and PIRCHE-II scores are significantly associated with dnDSA occurrence individually and in combination.ConclusionOur findings highlight the value of utilizing B cell and T cell epitope mismatch evaluation in living donor selection and immunological risk stratification to improve transplant outcomes.
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spelling doaj-art-a7c96915c11c4e1bac3827cf392cda6f2025-08-20T03:11:17ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-02-011610.3389/fimmu.2025.15087961508796De Novo donor-specific anti-HLA antibody risk stratification in kidney transplantation using a combination of B cell and T cell molecular mismatch assessmentElaine Chou-Wu0Matthias Niemann1Danny Youngs2Idoia Gimferrer3Immunogenetics/HLA Laboratory, Bloodworks Northwest, Seattle, WA, United StatesPIRCHE AG, Berlin, GermanyImmunogenetics/HLA Laboratory, Bloodworks Northwest, Seattle, WA, United StatesImmunogenetics/HLA Laboratory, Bloodworks Northwest, Seattle, WA, United StatesIntroductionThe presence of de novo donor-specific antibody (dnDSA) has detrimental effect on allograft outcomes in kidney transplantation. As humoral responses in transplantation are elicited targeting non-self-epitopes on donor HLA proteins, assessing HLA mismatches at the molecular level provides a refined means for immunological risk stratification.MethodsIn the present study, we utilized three HLA molecular mismatch assessment algorithms, Snow, HLAMatchmaker, and PIRCHE-II, to evaluate the independent and synergistic association of B cell and T cell epitope mismatches with dnDSA development in a cohort of 843 kidney transplant recipients.ResultsOur results demonstrated that B cell and T cell epitope mismatches at HLA Class I and DRB1/DQB1 loci are remarkably increased in dnDSA-positive recipients, even after normalization by allele mismatch numbers in individual study subjects. Furthermore, elevated Snow, verified eplet mismatches, and PIRCHE-II scores are significantly associated with dnDSA occurrence individually and in combination.ConclusionOur findings highlight the value of utilizing B cell and T cell epitope mismatch evaluation in living donor selection and immunological risk stratification to improve transplant outcomes.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1508796/fullHLA molecular mismatchmajor histocompatibility complex (MHC)risk stratificationkidney transplantationde novo DSASnow
spellingShingle Elaine Chou-Wu
Matthias Niemann
Danny Youngs
Idoia Gimferrer
De Novo donor-specific anti-HLA antibody risk stratification in kidney transplantation using a combination of B cell and T cell molecular mismatch assessment
Frontiers in Immunology
HLA molecular mismatch
major histocompatibility complex (MHC)
risk stratification
kidney transplantation
de novo DSA
Snow
title De Novo donor-specific anti-HLA antibody risk stratification in kidney transplantation using a combination of B cell and T cell molecular mismatch assessment
title_full De Novo donor-specific anti-HLA antibody risk stratification in kidney transplantation using a combination of B cell and T cell molecular mismatch assessment
title_fullStr De Novo donor-specific anti-HLA antibody risk stratification in kidney transplantation using a combination of B cell and T cell molecular mismatch assessment
title_full_unstemmed De Novo donor-specific anti-HLA antibody risk stratification in kidney transplantation using a combination of B cell and T cell molecular mismatch assessment
title_short De Novo donor-specific anti-HLA antibody risk stratification in kidney transplantation using a combination of B cell and T cell molecular mismatch assessment
title_sort de novo donor specific anti hla antibody risk stratification in kidney transplantation using a combination of b cell and t cell molecular mismatch assessment
topic HLA molecular mismatch
major histocompatibility complex (MHC)
risk stratification
kidney transplantation
de novo DSA
Snow
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1508796/full
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