{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:21:11Z","timestamp":1792164071667,"version":"4.4.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["PDF-2016-09-065"],"award-info":[{"award-number":["PDF-2016-09-065"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["JASN"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In single-center studies, HLA-DQ mismatches stimulate the most pathogenic donor-specific antibodies. However, because of limitations of transplant registries, this cannot be directly confirmed with registry-based analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated patients in the Scientific Registry of Transplant Recipients who were relisted after renal graft failure with new, unacceptable antigens corresponding to the HLA typing of their previous donor (UA-PD) as a proxy for donor-specific antibodies. Linear regression was applied to estimate the effects of HLA mismatches on UA-PD and the effects of UA-PD on calculated panel reactive antibody (cPRA) values for 4867 kidney recipients from 2010 to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Each additional HLA-DQ mismatch increased the probability of UA-PD by 25.2% among deceased donor transplant recipients and by 28.9% among living donor transplant recipients, significantly more than all other HLA loci (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.05). HLA-DQ UA-PD increased cPRA by 29.0% in living donor transplant recipients and by 23.5% in deceased donor transplant recipients, significantly more than all loci except for HLA-A in deceased donor transplant recipients (23.1%). African American deceased donor transplant recipients were significantly more likely than Hispanic and White recipients to develop HLA-DQ UA-PD; among living donor transplant recipients, African American or Hispanic recipients were significantly more likely to do so compared with White recipients. Models evaluating interactions between HLA-DR\/DQ mismatches revealed largely independent effects of HLA-DQ mismatches on HLA-DQ UA-PD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HLA-DQ mismatches had the strongest associations with UA-PD, an effect that was greatest in African American and Hispanic recipients. cPRA increases with HLA-DQ UA-PD were equivalent or larger than any other HLA locus. This suggests a need to consider the effects of HLA-DQ in kidney allocation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1681\/asn.2022030296","type":"journal-article","created":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T16:15:12Z","timestamp":1661962512000},"page":"2293-2305","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":20,"title":["HLA-DQ Mismatches Lead to More Unacceptable Antigens, Greater Sensitization, and Increased Disparities in Repeat Transplant Candidates"],"prefix":"10.1681","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1791-504X","authenticated-orcid":false,"given":"Dylan","family":"Isaacson","sequence":"first","affiliation":[{"name":"Comprehensive Transplant Center, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois"},{"name":"Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse D.","family":"Schold","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio"},{"name":"Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Gmeiner","sequence":"additional","affiliation":[{"name":"Department of Economics, London School of Economics, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah C.","family":"Copley","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke\u2019s Hospital, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7298-1387","authenticated-orcid":false,"given":"Vasilis","family":"Kosmoliaptsis","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke\u2019s Hospital, Cambridge, United Kingdom"},{"name":"National Institute for Health Research Blood and Transplant Research Unit in Organ Donation and Transplantation, University of Cambridge, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0320-9825","authenticated-orcid":false,"given":"Anat R.","family":"Tambur","sequence":"additional","affiliation":[{"name":"Comprehensive Transplant Center, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,12]]},"reference":[{"key":"B1-20250823","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.2215\/CJN.02380314","article-title":"Association between kidney transplant center performance and the survival benefit of transplantation versus dialysis","volume":"9","author":"Schold","year":"2014","journal-title":"Clin J Am Soc Nephrol"},{"key":"B2-20250823","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1001\/jamasurg.2014.2038","article-title":"Survival benefit of solid-organ transplant in the United States","volume":"150","author":"Rana","year":"2015","journal-title":"JAMA Surg"},{"issue":"Suppl 2","key":"B3-20250823","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1111\/ajt.16502","article-title":"OPTN\/SRTR 2019 Annual Data Report: Kidney","volume":"21","author":"Hart","year":"2021","journal-title":"Am J Transplant"},{"key":"B4-20250823","doi-asserted-by":"crossref","first-page":"182","DOI":"10.2215\/CJN.00700117","article-title":"Donor-specific antibodies in kidney transplant recipients","volume":"13","author":"Zhang","year":"2018","journal-title":"Clin J Am Soc Nephrol"},{"key":"B5-20250823","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1097\/TP.0b013e3181b11b72","article-title":"HLA-specific antibodies developed in the first year posttransplant are predictive of chronic rejection and renal graft loss","volume":"88","author":"Lee","year":"2009","journal-title":"Transplantation"},{"key":"B6-20250823","first-page":"171","article-title":"Detailed examination of HLA antibody development on renal allograft failure and function","author":"Zhu","year":"2008","journal-title":"Clin Transpl"},{"key":"B7-20250823","doi-asserted-by":"crossref","first-page":"2910","DOI":"10.1111\/ajt.15489","article-title":"The quest to decipher HLA immunogenicity: Telling friend from foe","volume":"19","author":"Tambur","year":"2019","journal-title":"Am J Transplant"},{"key":"B8-20250823","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1097\/MOT.0000000000000538","article-title":"Human leukocyte antigen matching in organ transplantation: What we know and how can we make it better (revisiting the past, improving the future)","volume":"23","author":"Tambur","year":"2018","journal-title":"Curr Opin Organ Transplant"},{"key":"B9-20250823","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1097\/MOT.0000000000000325","article-title":"HLA-DQ antibodies: Are they real? Are they relevant? Why so many?","volume":"21","author":"Tambur","year":"2016","journal-title":"Curr Opin Organ Transplant"},{"key":"B10-20250823","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1038\/ki.2014.106","article-title":"Impact of donor mismatches at individual HLA-A, -B, -C, -DR, and -DQ loci on the development of HLA-specific antibodies in patients listed for repeat renal transplantation","volume":"86","author":"Kosmoliaptsis","year":"2014","journal-title":"Kidney Int"},{"key":"B11-20250823","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1097\/TP.0b013e31827d62e3","article-title":"Incidence and impact of de novo donor-specific alloantibody in primary renal allografts","volume":"95","author":"Everly","year":"2013","journal-title":"Transplantation"},{"key":"B13-20250823","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1111\/j.1399-0012.1997.tb01028.x","article-title":"HLA-DQ matching in cadaveric renal transplantation","volume":"11","author":"Freedman","year":"1997","journal-title":"Clin Transplant"},{"key":"B14-20250823","first-page":"261","article-title":"The HLA-matching effect in different cohorts of kidney transplant recipients: 10 years later","author":"Sasaki","year":"2010","journal-title":"Clin Transpl"},{"key":"B15-20250823","doi-asserted-by":"crossref","first-page":"875","DOI":"10.2215\/CJN.11641115","article-title":"HLA-DQ mismatches and rejection in kidney transplant recipients","volume":"11","author":"Lim","year":"2016","journal-title":"Clin J Am Soc Nephrol"},{"key":"B16-20250823","doi-asserted-by":"crossref","first-page":"763","DOI":"10.2215\/CJN.10860917","article-title":"HLA-DQ mismatching and kidney transplant outcomes","volume":"13","author":"Leeaphorn","year":"2018","journal-title":"Clin J Am Soc Nephrol"},{"key":"B17-20250823","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1111\/ajt.16070","article-title":"Substituting imputation of HLA antigens for high-resolution HLA typing: Evaluation of a multiethnic population and implications for clinical decision making in transplantation","volume":"21","author":"Engen","year":"2021","journal-title":"Am J Transplant"},{"key":"B18-20250823","doi-asserted-by":"crossref","first-page":"1923","DOI":"10.1182\/blood-2004-03-0803","article-title":"Impact of HLA class I and class II high-resolution matching on outcomes of unrelated donor bone marrow transplantation: HLA-C mismatching is associated with a strong adverse effect on transplantation outcome","volume":"104","author":"Flomenberg","year":"2004","journal-title":"Blood"},{"key":"B19-20250823","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1016\/j.kint.2021.06.026","article-title":"Significance of HLA-DQ in kidney transplantation: Time to reevaluate human leukocyte antigen-matching priorities to improve transplant outcomes? An expert review and recommendations","volume":"100","author":"Tambur","year":"2021","journal-title":"Kidney Int"},{"key":"B20-20250823","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1681\/ASN.2021121642","article-title":"Immunosuppressant medication use in patients with kidney allograft failure: A prospective multicenter Canadian cohort study","volume":"33","author":"Knoll","year":"2022","journal-title":"J Am Soc Nephrol"},{"key":"B21-20250823","doi-asserted-by":"crossref","first-page":"683","DOI":"10.2215\/CJN.03720318","article-title":"Is there a need for additional DQ matching?","volume":"13","author":"S\u00fcsal","year":"2018","journal-title":"Clin J Am Soc Nephrol"},{"key":"B22-20250823","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1038\/s41581-018-0039-x","article-title":"HLA in transplantation","volume":"14","author":"Montgomery","year":"2018","journal-title":"Nat Rev Nephrol"},{"key":"B23-20250823","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1097\/TP.0b013e3182a452a5","article-title":"HLA-DQ barrier: Effects on cPRA calculations","volume":"96","author":"Tambur","year":"2013","journal-title":"Transplantation"},{"key":"B24-20250823","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1016\/j.kint.2016.06.029","article-title":"Twenty years of evolving trends in racial disparities for adult kidney transplant recipients","volume":"90","author":"Taber","year":"2016","journal-title":"Kidney Int"},{"key":"B25-20250823","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1159\/000479480","article-title":"Health disparities in kidney transplantation for African Americans","volume":"46","author":"Harding","year":"2017","journal-title":"Am J Nephrol"},{"key":"B26-20250823","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1097\/TP.0b013e3181a9ec89","article-title":"A lifetime versus a graft life approach redefines the importance of HLA matching in kidney transplant patients","volume":"88","author":"Meier-Kriesche","year":"2009","journal-title":"Transplantation"},{"key":"B27-20250823","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1056\/NEJMoa025056","article-title":"Effect of changing the priority for HLA matching on the rates and outcomes of kidney transplantation in minority groups","volume":"350","author":"Roberts","year":"2004","journal-title":"N Engl J Med"},{"key":"B28-20250823","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1053\/j.ajkd.2011.05.023","article-title":"Effect of eliminating priority points for HLA-B matching on racial disparities in kidney transplant rates","volume":"58","author":"Hall","year":"2011","journal-title":"Am J Kidney Dis"},{"key":"B29-20250823","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1001\/archsurg.2011.2220","article-title":"The association of community health indicators with outcomes for kidney transplant recipients in the United States","volume":"147","author":"Schold","year":"2012","journal-title":"Arch Surg"},{"key":"B30-20250823","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.trre.2016.10.006","article-title":"Immunosuppression for kidney transplantation: Where are we now and where are we going?","volume":"31","author":"Lim","year":"2017","journal-title":"Transplant Rev (Orlando)"}],"container-title":["Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1681\/ASN.2022030296","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T19:48:36Z","timestamp":1786132116000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1681\/ASN.2022030296"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":29,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1681\/asn.2022030296","relation":{},"ISSN":["1046-6673","1533-3450"],"issn-type":[{"value":"1046-6673","type":"print"},{"value":"1533-3450","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12]]},"assertion":[{"value":"2022-03-12","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-25","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}