Combined molecular mismatch scores for immunologic risk stratification in pediatric heart transplantation.

PURPOSE OF REVIEW: This article will review the use of HLA molecular mismatch algorithms to predict the risk of de-novo DSA and rejection in pediatric heart transplant recipients. Here, we will focus on results obtained using the combined algorithm approach pairing HLAMatchmaker or HLA-EMMA with PIRCHE-II.

RECENT FINDINGS: The combined algorithm approach was recently used to assess risk of de-novo DSA and rejection in a pediatric heart transplant cohort from Clinical Trials in Organ Transplant in Children 04/09. This approach to analyzing HLA molecular mismatch data allowed for a more granular assessment of de-novo DSA and rejection risk than any individual algorithm.

SUMMARY: Advances in HLA molecular mismatch methods may enable personalized immunosuppression management that improves outcomes of pediatric heart transplant recipients.