{"doi":"10.3389/fimmu.2020.580752","title":"Low Hydrophobic Mismatch Scores Calculated for HLA-A/B/DR/DQ Loci Improve Kidney Allograft Survival","abstract":"We evaluated the impact of human leukocyte antigen (HLA) disparity (immunogenicity; IM) on long-term kidney allograft survival. The IM was quantified based on physicochemical properties of the polymorphic linear donor/recipient HLA amino acids (the Cambridge algorithm) as a hydrophobic, electrostatic, amino acid mismatch scores (HMS\\AMS\\EMS) or eplet mismatch (EpMM) load. High-resolution HLA-A/B/DRB1/DQB1 types were imputed to calculate HMS for primary/re-transplant recipients of deceased donor transplants. The multiple Cox regression showed the association of HMS with graft survival and other confounders. The HMS integer 0-10 scale showed the most survival benefit between HMS 0 and 3. The Kaplan-Meier analysis showed that: the HMS=0 group had 18.1-year median graft survival, a 5-year benefit over HMS>0 group; HMS ≤ 3.0 had 16.7-year graft survival, a 3.8-year better than HMS>3.0 group; and, HMS ≤ 7.8 had 14.3-year grafts survival, a 1.8-year improvement over HMS>7.8 group. Stratification based on EMS, AMS or EpMM produced similar results. Additionally, the importance of HLA-DR with/without -DQ IM for graft survival was shown. In our simulation of 1,000 random donor/recipient pairs, 75% with HMS>3.0 were re-matched into HMS ≤ 3.0 and the remaining 25% into HMS≥7.8: after re-matching, the 13.5 years graft survival would increase to 16.3 years. This approach matches donors to recipients with low/medium IM donors thus preventing transplants with high IM donors.","journal":"Frontiers in Immunology","year":2020,"id":87128,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9593,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":444513,"name":"Beata Mierzejewska","orcid":null,"position":1,"is_corresponding":false},{"id":444514,"name":"Jadwiga Borucka","orcid":null,"position":2,"is_corresponding":false},{"id":443528,"name":"Robert Liwski","orcid":"0000-0002-4796-9893","position":3,"is_corresponding":false},{"id":443529,"name":"Anna L. Greenshields","orcid":"0000-0002-9030-6104","position":4,"is_corresponding":false},{"id":401531,"name":"Joshua D. Breidenbach","orcid":"0000-0002-5892-1879","position":5,"is_corresponding":false},{"id":444515,"name":"Bradley Gehring","orcid":null,"position":6,"is_corresponding":false},{"id":443530,"name":"Shravan Leonard‐Murali","orcid":"0000-0003-4476-4937","position":7,"is_corresponding":false},{"id":443531,"name":"Sadik Khuder","orcid":"0000-0003-2673-6326","position":8,"is_corresponding":false},{"id":387924,"name":"Michael A. Rees","orcid":"0000-0002-0345-7810","position":9,"is_corresponding":false},{"id":443532,"name":"Robert Green","orcid":"0000-0002-3792-2725","position":10,"is_corresponding":false},{"id":443533,"name":"Stanislaw M. Stepkowski","orcid":"0000-0003-3664-533X","position":11,"is_corresponding":false},{"id":443527,"name":"Dulat Bekbolsynov","orcid":"0000-0002-3626-4310","position":0,"is_corresponding":true}],"reference_count":50,"raw_metadata":null,"created_at":"2026-07-18T21:59:31.247492Z","pmid":"33193383","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}