{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T13:27:15Z","timestamp":1793453235648,"version":"4.5.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T00:00:00Z","timestamp":1620950400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T00:00:00Z","timestamp":1620950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Commun Biol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Compatibility for human leukocyte antigen (HLA) genes between transplant donors and recipients improves graft survival but prospective matching is rarely performed due to the vast heterogeneity of this gene complex. To reduce complexity, we have combined next-generation sequencing and in silico mapping to determine transplant population frequencies and matching probabilities of 150 antibody-binding eplets across all 11 classical HLA genes in 2000 ethnically heterogeneous renal patients and donors. We show that eplets are more common and uniformly distributed between donors and recipients than the respective HLA isoforms. Simulations of targeted eplet matching shows that a high degree of overall compatibility, and perfect identity at the clinically important HLA class II loci, can be obtained within a patient waiting list of approximately 250 subjects. Internal epitope-based allocation is thus feasible for most major renal transplant programs, while regional or national sharing may be required for other solid organs.<\/jats:p>","DOI":"10.1038\/s42003-021-01989-3","type":"journal-article","created":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T06:03:17Z","timestamp":1620972197000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["High-throughput sequencing defines donor and recipient HLA B-cell epitope frequencies for prospective matching in transplantation"],"prefix":"10.1038","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4777-165X","authenticated-orcid":false,"given":"Jenny N.","family":"Tran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1900-715X","authenticated-orcid":false,"given":"Oliver P.","family":"G\u00fcnther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen R.","family":"Sherwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz","family":"Fenninger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenka L.","family":"Allan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Lan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Sapir-Pichhadze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rene","family":"Duquesnoy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans","family":"Claas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2855-4120","authenticated-orcid":false,"given":"Steven G. E.","family":"Marsh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Robert","family":"McMaster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6466-8251","authenticated-orcid":false,"given":"Paul A.","family":"Keown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Genome Canada Transplant Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Canada Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stirling","family":"Bryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Caulfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Ragoussis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Oualkacha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Tinckam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Liwski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heloise","family":"Cardinal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sacha A.","family":"De Serres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chee Loong","family":"Saw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Mengel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Banu","family":"Sis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noureddine","family":"Berka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"McManus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Jos\u00e9e","family":"Hebert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard J.","family":"Foster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Rossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph H.","family":"Borchers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciriaco A.","family":"Piccirillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantin","family":"Polychronakos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Jevnikar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"Cullis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Filler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harvey","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany","family":"Foster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Gill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Joseph","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee Anne","family":"Tibbles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul","family":"Humar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Shechter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prosanto","family":"Chaudhury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Fernandez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Fowler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryce","family":"Kiberd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagbir","family":"Gill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Chantal","family":"Fortin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Klarenbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Balshaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Mital","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Istvan","family":"Mucsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Ostrow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calvin","family":"Stiller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rulan S.","family":"Parekh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Richard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne","family":"Senecal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Blydt-Hansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"United States Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Erlich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Gebel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Weimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Kaplan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilbert","family":"Burckart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"United Kingdom Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Middleton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2855-4120","authenticated-orcid":false,"given":"Steven G. E.","family":"Marsh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Netherlands Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Tilanus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teun","family":"van Gelder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Germany Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Opelz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Oellerich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"France Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Marquet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"New Zealand Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Marra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Hungary Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zolt\u00e1n","family":"Kal\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,14]]},"reference":[{"key":"1989_CR1","doi-asserted-by":"publisher","first-page":"2093","DOI":"10.1111\/j.1600-6143.2011.03686.x","volume":"11","author":"M Tonelli","year":"2011","unstructured":"Tonelli, M. et al. Systematic review: Kidney transplantation compared with dialysis in clinically relevant outcomes. Am. J. Transplant. 11, 2093\u20132109 (2011).","journal-title":"Am. J. Transplant."},{"key":"1989_CR2","doi-asserted-by":"publisher","first-page":"e522","DOI":"10.1097\/TXD.0000000000000974","volume":"6","author":"R Fu","year":"2020","unstructured":"Fu, R., Sekercioglu, N., Berta, W. & Coyte, P. C. Cost-effectiveness of deceased-donor renal transplant versus dialysis to treat end-stage renal disease. Transplant. Direct 6, e522 (2020).","journal-title":"Transplant. Direct"},{"key":"1989_CR3","unstructured":"Organ replacement in Canada: CORR annual statistics, CIHI. https:\/\/www.cihi.ca\/en\/organ-replacement-in-canada-corr-annual-statistics-2019 (2019)."},{"key":"1989_CR4","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1111\/j.1600-6143.2011.03840.x","volume":"12","author":"J Sellar\u00e9s","year":"2012","unstructured":"Sellar\u00e9s, J. et al. Understanding the causes of kidney transplant failure: the dominant role of antibody-mediated rejection and nonadherence. Am. J. Transplant. 12, 388\u2013399 (2012).","journal-title":"Am. J. Transplant."},{"key":"1989_CR5","doi-asserted-by":"publisher","first-page":"1711","DOI":"10.1681\/ASN.2014060588","volume":"26","author":"PF Halloran","year":"2015","unstructured":"Halloran, P. F. et al. Disappearance of T cell-mediated rejection despite continued antibody-mediated rejection in late kidney transplant recipients. J. Am. Soc. Nephrol. 26, 1711\u20131720 (2015).","journal-title":"J. Am. Soc. Nephrol."},{"key":"1989_CR6","first-page":"D948","volume":"48","author":"J Robinson","year":"2020","unstructured":"Robinson, J. et al. IPD-IMGT\/HLA Database. Nucleic Acids Res. 48, D948\u2013D955 (2020).","journal-title":"Nucleic Acids Res."},{"key":"1989_CR7","doi-asserted-by":"crossref","unstructured":"Montgomery, R. A., Tatapudi, V. S., Leffell, M. S. & Zachary, A. A. HLA in transplantation. Nat. Rev. Nephrol. 14, 558\u2013570 (2018).","DOI":"10.1038\/s41581-018-0039-x"},{"key":"1989_CR8","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1097\/01.tp.0000269725.74189.b9","volume":"84","author":"G Opelz","year":"2007","unstructured":"Opelz, G. & D\u00f6hler, B. Effect of human leukocyte antigen compatibility on kidney graft survival: Comparative analysis of two decades. Transplantation 84, 137\u2013143 (2007).","journal-title":"Transplantation"},{"key":"1989_CR9","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1111\/j.1744-313X.2010.00956.x","volume":"37","author":"G Opelz","year":"2010","unstructured":"Opelz, G. Commentary: Is HLA matching useful? Int. J. Immunogenet. 37, 327\u2013328 (2010).","journal-title":"Int. J. Immunogenet."},{"key":"1989_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.trim.2014.04.004","volume":"31","author":"RJ Duquesnoy","year":"2014","unstructured":"Duquesnoy, R. J. HLA epitope based matching for transplantation. Transpl. Immunol. 31, 1\u20136 (2014).","journal-title":"Transpl. Immunol."},{"key":"1989_CR11","doi-asserted-by":"publisher","first-page":"3114","DOI":"10.1111\/ajt.12478","volume":"13","author":"C Wiebe","year":"2013","unstructured":"Wiebe, C. et al. Class II HLA epitope matching\u2014a strategy to minimize de novo donor-specific antibody development and improve outcomes. Am. J. Transplant. 13, 3114\u20133122 (2013).","journal-title":"Am. J. Transplant."},{"key":"1989_CR12","doi-asserted-by":"publisher","unstructured":"Sapir-Pichhadze, R. et al. HLA-DR and -DQ eplet mismatches and transplant glomerulopathy: A nested case-control study. Am. J. Transplant. https:\/\/doi.org\/10.1111\/ajt.12968 (2015).","DOI":"10.1111\/ajt.12968"},{"key":"1989_CR13","doi-asserted-by":"publisher","first-page":"1605","DOI":"10.1002\/jcc.20084","volume":"25","author":"EF Pettersen","year":"2004","unstructured":"Pettersen, E. F. et al. UCSF Chimera\u2014a visualization system for exploratory research and analysis. J. Comput. Chem. 25, 1605\u20131612 (2004).","journal-title":"J. Comput. Chem."},{"key":"1989_CR14","doi-asserted-by":"publisher","first-page":"2593","DOI":"10.1074\/jbc.M114.607028","volume":"290","author":"C Hassan","year":"2015","unstructured":"Hassan, C. et al. Naturally processed non-canonical HLA-A*02:01 presented peptides. J. Biol. Chem. 290, 2593\u20132603 (2015).","journal-title":"J. Biol. Chem."},{"key":"1989_CR15","doi-asserted-by":"publisher","first-page":"13611","DOI":"10.1074\/jbc.M111.320374","volume":"287","author":"S Tollefsen","year":"2012","unstructured":"Tollefsen, S. et al. Structural and functional studies of trans-encoded HLA-DQ2.3 (DQA1*03:01\/DQB1*02:01) protein molecule. J. Biol. Chem. 287, 13611\u201313619 (2012).","journal-title":"J. Biol. Chem."},{"key":"1989_CR16","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1016\/j.humimm.2006.08.001","volume":"67","author":"RJ Duquesnoy","year":"2006","unstructured":"Duquesnoy, R. J. A structurally based approach to determine HLA compatibility at the humoral immune level. Hum. Immunol. 67, 847\u2013862 (2006).","journal-title":"Hum. Immunol."},{"key":"1989_CR17","doi-asserted-by":"crossref","unstructured":"El-Awar, N., Jucaud, V. & Nguyen, A. HLA Epitopes: the targets of monoclonal and alloantibodies defined. J. Immunol. Res. 2017, 3406230 (2017).","DOI":"10.1155\/2017\/3406230"},{"key":"1989_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fimmu.2016.00582","volume":"7","author":"J Marino","year":"2016","unstructured":"Marino, J., Paster, J. & Benichou, G. Allorecognition by T lymphocytes and allograft rejection. Front. Immunol. 7, 1\u20139 (2016).","journal-title":"Front. Immunol."},{"key":"1989_CR19","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1016\/j.it.2016.09.003","volume":"37","author":"ML Alegre","year":"2016","unstructured":"Alegre, M. L., Lakkis, F. G. & Morelli, A. E. Antigen presentation in transplantation. Trends Immunol. 37, 831\u2013843 (2016).","journal-title":"Trends Immunol."},{"key":"1989_CR20","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1016\/j.humimm.2012.12.004","volume":"74","author":"HG Otten","year":"2013","unstructured":"Otten, H. G., Calis, J. J. A., Ke\u015fmir, C., van Zuilen, A. D. & Spierings, E. Predicted indirectly recognizable HLA epitopes presented by HLA-DR correlate with the de novo development of donor-specific HLA IgG antibodies after kidney transplantation. Hum. Immunol. 74, 290\u2013296 (2013).","journal-title":"Hum. Immunol."},{"key":"1989_CR21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fimmu.2019.00880","volume":"10","author":"K Geneugelijk","year":"2019","unstructured":"Geneugelijk, K. et al. Exploratory study of predicted indirectly recognizable hla epitopes in mismatched hematopoietic cell transplantations. Front. Immunol. 10, 1\u20138 (2019).","journal-title":"Front. Immunol."},{"key":"1989_CR22","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.trim.2018.06.006","volume":"50","author":"L Dani\u00ebls","year":"2018","unstructured":"Dani\u00ebls, L. et al. The clinical significance of epitope mismatch load in kidney transplantation: a multicentre study. Transpl. Immunol. 50, 55\u201359 (2018).","journal-title":"Transpl. Immunol."},{"key":"1989_CR23","doi-asserted-by":"publisher","first-page":"3353","DOI":"10.1681\/ASN.2017030287","volume":"28","author":"C Wiebe","year":"2017","unstructured":"Wiebe, C. et al. Class II eplet mismatch modulates tacrolimus trough levels required to prevent donor-specific antibody development. J. Am. Soc. Nephrol. 28, 3353\u20133362 (2017).","journal-title":"J. Am. Soc. Nephrol."},{"key":"1989_CR24","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1111\/tan.12093","volume":"81","author":"SJ Mack","year":"2013","unstructured":"Mack, S. J. et al. Common and well-documented HLA alleles: 2012 update to the CWD catalogue. Tissue Antigens 81, 194\u2013203 (2013).","journal-title":"Tissue Antigens"},{"key":"1989_CR25","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1038\/s41409-019-0476-6","volume":"54","author":"M Aljurf","year":"2019","unstructured":"Aljurf, M. et al. Worldwide Network for Blood & Marrow Transplantation (WBMT) special article, challenges facing emerging alternate donor registries\u201d. Bone Marrow Transplant. 54, 1179\u20131188 (2019).","journal-title":"Bone Marrow Transplant."},{"key":"1989_CR26","unstructured":"Census Profile, 2016 Census\u2014British Columbia, Canada. https:\/\/www12.statcan.gc.ca\/census-recensement\/2016\/dp-pd\/prof\/details\/page.cfm?Lang=E&SearchText=Canada&SearchType=Begins&SearchPR=01&TABID=1&G=1&Geo1=PR&Code1=59&Geo2=PR&Code2=01&type=0&B1=Ethnicorigin (2016)."},{"key":"1989_CR27","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1111\/nep.13548","volume":"24","author":"D Lee","year":"2019","unstructured":"Lee, D., Kanellis, J. & Mulley, W. R. Allocation of deceased donor kidneys: a review of international practices. Nephrology 24, 591\u2013598 (2019).","journal-title":"Nephrology"},{"key":"1989_CR28","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1159\/000358798","volume":"76","author":"JM Tiercy","year":"2014","unstructured":"Tiercy, J. M. & Claas, F. Impact of HLA diversity on donor selection in organ and stem cell transplantation. Hum. Hered. 76, 178\u2013186 (2014).","journal-title":"Hum. Hered."},{"key":"1989_CR29","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1007\/s40472-019-00264-z","volume":"6","author":"JS Gill","year":"2019","unstructured":"Gill, J. S. et al. Allocation and reporting of deceased donor kidney transplantation in Canada. Curr. Transplant. Rep. 6, 344\u2013347 (2019).","journal-title":"Curr. Transplant. Rep."},{"key":"1989_CR30","doi-asserted-by":"publisher","first-page":"2921","DOI":"10.1111\/ajt.13347","volume":"15","author":"C Wiebe","year":"2015","unstructured":"Wiebe, C. et al. Rates and determinants of progression to graft failure in kidney allograft recipients with de novo donor-specific antibody. Am. J. Transplant. 15, 2921\u20132930 (2015).","journal-title":"Am. J. Transplant."},{"key":"1989_CR31","doi-asserted-by":"publisher","first-page":"1084","DOI":"10.1111\/j.1432-2277.2011.01312.x","volume":"24","author":"ISA Ntokou","year":"2011","unstructured":"Ntokou, I. S. A. et al. Long-term follow up for anti-HLA donor specific antibodies postrenal transplantation: High immunogenicity of HLA class II graft molecules. Transpl. Int. 24, 1084\u20131093 (2011).","journal-title":"Transpl. Int."},{"key":"1989_CR32","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1681\/ASN.2014040326","volume":"27","author":"G Guidicelli","year":"2016","unstructured":"Guidicelli, G. et al. Non-complement-binDing de novo donor-specific anti-HLA antibodies and kidney allograft survival. J. Am. Soc. Nephrol. 27, 615\u2013625 (2016).","journal-title":"J. Am. Soc. Nephrol."},{"key":"1989_CR33","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1016\/j.kint.2019.10.028","volume":"97","author":"R Sapir-Pichhadze","year":"2020","unstructured":"Sapir-Pichhadze, R. et al. Epitopes as characterized by antibody-verified eplet mismatches determine risk of kidney transplant loss. Kidney Int. 97, 778\u2013785 (2020).","journal-title":"Kidney Int."},{"key":"1989_CR34","doi-asserted-by":"publisher","first-page":"2139","DOI":"10.1111\/ajt.13707","volume":"16","author":"V Kosmoliaptsis","year":"2016","unstructured":"Kosmoliaptsis, V. et al. Alloantibody responses after renal transplant failure can be better predicted by donor\u2013recipient HLA amino acid sequence and physicochemical disparities than conventional HLA matching. Am. J. Transplant. 16, 2139\u20132147 (2016).","journal-title":"Am. J. Transplant."},{"key":"1989_CR35","doi-asserted-by":"publisher","first-page":"2010","DOI":"10.3389\/fimmu.2018.02010","volume":"9","author":"AR Tambur","year":"2018","unstructured":"Tambur, A. R. HLA-Epitope matching or eplet risk stratification: the devil is in the details. Front. Immunol. 9, 2010 (2018).","journal-title":"Front. Immunol."},{"key":"1989_CR36","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1111\/ajt.15672","volume":"20","author":"A Hart","year":"2020","unstructured":"Hart, A. et al. OPTN\/SRTR 2018 Annual data report: kidney. Am. J. Transplant. 20, 20\u2013130 (2020).","journal-title":"Am. J. Transplant."},{"key":"1989_CR37","unstructured":"About Eurotransplant\u2014Eurotransplant. https:\/\/www.eurotransplant.org\/ (2019)."},{"key":"1989_CR38","unstructured":"Home\u2014NHS Blood and Transplant. https:\/\/www.nhsbt.nhs.uk\/ (2019)."},{"key":"1989_CR39","unstructured":"ANZDATA\u2014Australia and New Zealand Dialysis and Transplant Registry\u2014ANZDATA. https:\/\/www.anzdata.org.au\/anzdata\/ (2019)."},{"key":"1989_CR40","doi-asserted-by":"publisher","unstructured":"Heidt, S., Witvliet, M. D., Haasnoot, G. W. & Claas, F. H. J. The 25th anniversary of the Eurotransplant Acceptable Mismatch program for highly sensitized patients. Transpl. Immunol. https:\/\/doi.org\/10.1016\/j.trim.2015.08.006. (2015)","DOI":"10.1016\/j.trim.2015.08.006"},{"key":"1989_CR41","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1097\/TP.0b013e3181b04a5f","volume":"88","author":"FHJ Claas","year":"2009","unstructured":"Claas, F. H. J., Rahmel, A. & Doxiadis, I. I. N. Enhanced kidney allocation to highly sensitized patients by the acceptable mismatch program. Transplantation 88, 447\u2013452 (2009).","journal-title":"Transplantation"},{"key":"1989_CR42","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1111\/j.1432-2277.2004.tb00379.x","volume":"17","author":"RJ Duquesnoy","year":"2004","unstructured":"Duquesnoy, R. J., Witvliet, M., Doxiadis, I. I. N., De Fijter, H. & Claas, F. H. J. HLAMatchmaker-based strategy to identify acceptable HLA class I mismatches for highly sensitized kidney transplant candidates. Transpl. Int. 17, 22\u201330 (2004).","journal-title":"Transpl. Int."},{"key":"1989_CR43","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1111\/petr.12815","volume":"20","author":"JY Kausman","year":"2016","unstructured":"Kausman, J. Y. et al. Application of an epitope-based allocation system in pediatric kidney transplantation. Pediatr. Transplant. 20, 931\u2013938 (2016).","journal-title":"Pediatr. Transplant."},{"key":"1989_CR44","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1002\/spe.4380211102","volume":"21","author":"TMJ Fruchterman","year":"1991","unstructured":"Fruchterman, T. M. J. & Reingold, E. M. Graph drawing by force\u2010directed placement. Softw. Pract. Exp. 21, 1129\u20131164 (1991).","journal-title":"Softw. Pract. Exp."},{"key":"1989_CR45","doi-asserted-by":"publisher","first-page":"1639","DOI":"10.1101\/gr.092759.109","volume":"19","author":"J Connors","year":"2009","unstructured":"Connors, J. et al. Circos: an information aesthetic for comparative genomics. Genome Res. 19, 1639\u20131645 (2009).","journal-title":"Genome Res."},{"key":"1989_CR46","doi-asserted-by":"publisher","first-page":"2811","DOI":"10.1093\/bioinformatics\/btu393","volume":"30","author":"Z Gu","year":"2014","unstructured":"Gu, Z., Gu, L., Eils, R., Schlesner, M. & Brors, B. Circlize implements and enhances circular visualization in R. Bioinformatics 30, 2811\u20132812 (2014).","journal-title":"Bioinformatics"}],"container-title":["Communications Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s42003-021-01989-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s42003-021-01989-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s42003-021-01989-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T14:17:40Z","timestamp":1670077060000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s42003-021-01989-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,14]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["1989"],"URL":"https:\/\/doi.org\/10.1038\/s42003-021-01989-3","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-50893\/v1","asserted-by":"object"}]},"ISSN":["2399-3642"],"issn-type":[{"value":"2399-3642","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,14]]},"assertion":[{"value":"18 August 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 March 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"583"}}