title: Acceptable mismatching at the class II epitope level: the Canadian experience.
abstract: OBJECTIVE
  To summarize the evidence concerning human leukocyte antigen (HLA) epitope mismatch analysis as a means to predict donor-specific antibody (DSA) development and allograft survival.
  
  
  RESULTS
  HLA epitope mismatch analysis outperforms traditional whole molecule antigen mismatch for predicting the risk of de-novo DSA development. By analyzing the number of epitope mismatches for a given donor-recipient pair, thresholds have been identified to stratify patients into those at high or low risk of de-novo DSA development. Epitope specificity assignment in patients who develop de-novo DSA compared with controls who do not provides an opportunity to study the relative immunogenicity of mismatched HLA epitopes.
  
  
  CONCLUSIONS
  Recognizing that de-novo DSA is a major cause of graft loss, HLA epitope mismatch analysis is a strategy to minimize de-novo DSA development and improve long-term graft survival.
authors: aDepartment of Medicine and Immunology, University of Manitoba bDiagnostic Services of Manitoba, Winnipeg, Manitoba, Canada.
authors: Chris
authors: C
authors: Wiebe
authors: Peter
authors: P
authors: Nickerson
mesh_terms: D000906:Antibodies / Q000276:immunology; D002170:Canada; D000939:Epitopes / Q000276:immunology*; D006085:Graft Survival / Q000276:immunology; D000949:Histocompatibility Antigens Class II / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D014184:Transplantation, Homologous
chemical_list: D000906:Antibodies; D000939:Epitopes; D000949:Histocompatibility Antigens Class II