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

Author:

Aldea Paul Luchian1,Santionean Maria Diana2,Elec Alina1ORCID,Munteanu Adriana1,Antal Oana13ORCID,Loga Luminita1,Moisoiu Tudor13,Elec Florin Ioan13,Delean Dan4,Bulata Bogdan4,Rachisan (Bot) Andreea Liana4

Affiliation:

1. Clinical Institute of Urology and Renal Transplantation, 400006 Cluj-Napoca, Romania

2. Department of Mother and Child, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania

3. Department of Urology, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania

4. Department of Mother and Child, Discipline of Pediatrics II, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania

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.

Publisher

MDPI AG

Subject

Pediatrics, Perinatology and Child Health

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