High-throughput sequencing defines donor and recipient HLA B-cell epitope frequencies for prospective matching in transplantation

Abstract 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 in silico mapping determine population frequencies probabilities 150 antibody-binding eplets across all 11 classical HLA 2000 ethnically heterogeneous renal patients donors. We show that are more common uniformly distributed than respective isoforms. Simulations targeted eplet shows a high degree overall compatibility, perfect identity at clinically important class II loci, can be obtained within patient waiting list approximately 250 subjects. Internal epitope-based allocation thus feasible most major programs, while regional or national sharing may required other solid organs.