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. 2023 Oct 30;10(11):1756.
doi: 10.3390/children10111756.

An Integrated Approach Using HLAMatchmaker and Pirche II for Epitopic Matching in Pediatric Kidney Transplant-A Romanian Single-Center Study

Paul Luchian Aldea  1 , Maria Diana Santionean  2 , Alina Elec  1 , Adriana Munteanu  1 , Oana Antal  1   3 , Luminita Loga  1 , Tudor Moisoiu  1   3 , Florin Ioan Elec  1   3 , Dan Delean  4 , Bogdan Bulata  4 , Andreea Liana Rachisan Bot  4
Affiliations

An Integrated Approach Using HLAMatchmaker and Pirche II for Epitopic Matching in Pediatric Kidney Transplant-A Romanian Single-Center Study

Paul Luchian Aldea et al. Children (Basel). .

Abstract

(1) Background: Renal transplantation (KT) is the most efficient treatment for chronic kidney disease among pediatric patients. Antigenic matching and epitopic load should be the main criteria for choosing a renal graft in pediatric transplantation. Our study aims to compare the integration of new histocompatibility predictive algorithms with classical human leukocyte antigen (HLA) matching regarding different types of pediatric renal transplants. (2) Methods: We categorized our cohort of pediatric patients depending on their risk level, type of donor and type of transplantation, delving into discussions surrounding their mismatching values in relation to both the human leukocyte antigen Matchmaker software (versions 4.0. and 3.1.) and the most recent version of the predicted indirectly identifiable HLA epitopes (PIRCHE) II score. (3) Results: We determined that the higher the antigen mismatch, the higher the epitopic load for both algorithms. The HLAMatchmaker algorithm reveals a noticeable difference in eplet load between living and deceased donors, whereas PIRCHE II does not show the same distinction. Dialysis recipients have a higher count of eplet mismatches, which demonstrates a significant difference according to the transplantation type. Our results are similar to those of four similar studies available in the current literature. (4) Conclusions: We suggest that an integrated data approach employing PIRCHE II and HLAMatchmaker algorithms better predicts histocompatibility in KT than classical HLA matching.

Keywords: HLAMatchmaker; PIRCHE II; epitope; graft; kidney; mismatch; pediatric; renal; transplantation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) Frequency histogram for PIRCHE II score. (b) Frequency histogram for epitopic score (HLA matchmaker).
Figure 2
Figure 2
(a) Correlation between the antigenic mismatches (MM) and PIRCHE II score. (b) Correlation between the antigenic mismatches (MM) and HLA matchmaker score.
Figure 3
Figure 3
(a) Box-plot showing the mean difference of PIRCHE II score between the two subgroups. (b) Box-plot showing the mean difference of HLA matchmaker score between the two subgroups.
Figure 4
Figure 4
Boxplot showing the HLA matchmaker differences between deceased (DD) and living donors (LD).
Figure 5
Figure 5
(a) Boxplot showing the PIRCHE II differences between the type of transplantation; group 1—non-preemptive, group 2—preemptive. (b) Boxplot showing the HLA matchmaker score differences between the type of transplantation; group 1—non-preemptive, group 2—preemptive.
See this image and copyright information in PMC

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