You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Acceptable mismatching at the class II epitope level: the Canadian experience

Wiebe, Chrisa; Nickerson, Petera,b

Current Opinion in Organ Transplantation:
doi: 10.1097/MOT.0000000000000104
HISTOCOMPATIBILITY: Edited by RenE J. Duquesnoy

Purpose of review: 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.

Recent findings: 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.

Summary: 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.

Author Information

aDepartment of Medicine and Immunology, University of Manitoba

bDiagnostic Services of Manitoba, Winnipeg, Manitoba, Canada

Correspondence to Peter Nickerson, Canadian Blood Services Building, 312-777 William Avenue, Winnipeg, Manitoba R3E 3R4, Canada. Tel: +1 204 789 1025; fax +1 204 789 3942; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins