The diagnosis of AMR required at least two of the following three criteria: (1) positive C4d staining on immunofluorescence, (2) presence of donor–specific anti–HLA antibody, and (3) characteristic histologic changes of AMR. Currently, matching at the HLA-DQ locus is not considered in the allocation pathway for deceased donor kidneys.

Using the information on UAM and the potential donor's complete HLA typing, prediction of the crossmatch result, the so called 'virtual crossmatch', is possible. USA.gov. This article contains supplemental material online at http://cjasn.asnjournals.org/lookup/suppl/doi:10.2215/CJN.11641115/-/DCSupplemental.

The dates of the first episode of acute rejection that occurred within the first 6 months after transplantation were available starting in 1997, whereas the dates of subsequent episodes were only consistently reported starting in 2004. Of those who have experienced graft loss, the proportions of recipients who had received HLA-DQ matched and mismatched kidneys and had graft loss that was attributed to acute rejection were 4.8% and 16.1%, respectively (P=0.07). Copyright © 2020 Elsevier Inc. except certain content provided by third parties. We have also shown that HLA-DR was an effect modifier between HLA-DQ mismatches and risk of AMR, such that the association between HLA-DQ mismatches and risk of AMR may be more important in recipients who have received HLA-DR mismatched kidneys. Compared with recipients of zero HLA-DQ mismatched kidneys, the adjusted hazard ratios for any and late rejections in recipients who had received one or two HLA-DQ mismatched kidneys were 1.54 (95% confidence interval [95% CI], 1.08 to 2.19) and 2.85 (95% CI, 1.05 to 7.75), respectively. Human leukocyte antigen mismatches associated with increased risk of rejection, graft failure, and death independent of initial immunosuppression in renal transplant recipients. MM, mismatched. The aims of this study are to examine the association between HLA-DQ mismatches and acute rejection and graft loss after kidney transplantation and assess whether HLA-DQ mismatches in the presence of compatibility for HLA-DR have any significant effect on graft outcomes. Despite these findings, the clinical importance of broad antigen HLA-DQ mismatches in predicting acute rejection after kidney transplantation independent of the effects of HLA matching at the ABDR loci has not been examined (7). Of those who had received one or two HLA-DQ mismatched kidneys (n=467), 58 (12%), 30 (6%), and 26 (6%) had zero mismatches at the HLA-A, HLA-B, and HLA-DR loci, respectively. A structurally based approach to determine HLA compatibility at the humoral immune level. Class II HLA epitope matching-A strategy to minimize de novo donor-specific antibody development and improve outcomes. We aimed to determine the effect of HLA-DQ mismatches on renal allograft outcomes. HLA-A, HLA-B, and HLA-DR mismatches were not effect modifiers between HLA-DQ mismatches and any rejection, early rejection, and late rejection. Our study findings highlight the importance of establishing HLA-DQ mismatches before transplantation to better define the immunologic risk of each potential kidney transplant candidate and potentially minimize sensitization against HLA-DQ antigen and subsequent development of de novo antibody, which may be particularly important in pediatric or younger patients who are likely to require future retransplantation.