EpViX: A cloud-based tool for epitope reactivity analysis and epitope virtual crossmatching to identify low immunologic risk donors for sensitized recipients.

One of the challenges facing solid organ transplantation programs globally is the identification of low immunological risk donors for sensitized recipients by HLA allele genotype. Because recognition of donor HLA alleles by host antibodies is at the core of organ rejection, the objective of this work was to develop a new version of the EpHLA software, named EpViX, which uses an HLAMatchmaker algorithm and performs automated epitope virtual crossmatching at the initiation of the organ donation process. EpViX is a free, web-based application developed for use over the internet on a tablet, smartphone or computer. This program was developed using the Ruby programming language and the Ruby-on-Rails framework. To improve the user experience, the EpViX software interface was developed based on the best human–computer interface practices. To simplify epitope analysis and virtual crossmatching, the program was integrated with important available web-based resources, such as OPTN, IMGT/HLA and the International HLA Epitope Registry. We successfully developed a program that allows people to work collaboratively and effectively during the donation process by accurately predicting negative crossmatches, saving time and other resources.

[1]  R. Duquesnoy,et al.  HLAMatchmaker: a molecularly based algorithm for histocompatibility determination. II. Verification of the algorithm and determination of the relative immunogenicity of amino acid triplet-defined epitopes. , 2002, Human immunology.

[2]  A. Laupacis,et al.  Immune Sensitization and Mortality in Wait-Listed Kidney Transplant Candidates. , 2016, Journal of the American Society of Nephrology : JASN.

[3]  M. Marrari,et al.  16th IHIW: A Website for Antibody‐Defined HLA Epitope Registry , 2012, International journal of immunogenetics.

[4]  I. Doxiadis,et al.  HLAmatchmaker: a molecularly based algorithm for histocompatibility determination. III. Effect of matching at the HLA-A,B amino acid triplet level on kidney transplant survival1 , 2003, Transplantation.

[5]  D. Roelen,et al.  THE NUMBER OF AMINO ACID TRIPLET DIFFERENCES BETWEEN PATIENT AND DONOR IS PREDICTIVE FOR THE ANTIBODY REACTIVITY AGAINST MISMATCHED HUMAN LEUKOCYTE ANTIGENS1 , 2004, Transplantation.

[6]  L. Sharples,et al.  Ten-Year Experience of Selective Omission of the Pretransplant Crossmatch Test in Deceased Donor Kidney Transplantation , 2010, Transplantation.

[7]  A. Rahmel,et al.  Enhanced kidney allocation to highly sensitized patients by the acceptable mismatch program. , 2009, Transplantation.

[8]  S. J. H. do Monte,et al.  First report on the antibody verification of HLA-DR, HLA-DQ and HLA-DP epitopes recorded in the HLA Epitope Registry. , 2014, Human immunology.

[9]  M. Melcher,et al.  Center‐Defined Unacceptable HLA Antigens Facilitate Transplants for Sensitized Patients in a Multi‐Center Kidney Exchange Program , 2014, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[10]  Pedro de Alcântara dos Santos Neto,et al.  EpHLA: an innovative and user-friendly software automating the HLAMatchmaker algorithm for antibody analysis. , 2011, Transplant immunology.

[11]  S. J. H. do Monte,et al.  First report on the antibody verification of HLA-ABC epitopes recorded in the website-based HLA Epitope Registry. , 2014, Tissue antigens.

[12]  D. Roelen,et al.  Immunogenetics and immunology of transplantation in Leiden. , 2014, Transplant immunology.

[13]  René J Duquesnoy,et al.  HLAMatchmaker: a molecularly based algorithm for histocompatibility determination. I. Description of the algorithm. , 2002, Human immunology.

[14]  I. Doxiadis,et al.  The acceptable mismatch program as a fast tool for highly sensitized patients awaiting a cadaveric kidney transplantation: short waiting time and excellent graft outcome. , 2004, Transplantation.

[15]  R. Duquesnoy HLAMMATCHMAKER: a molecularly based donor selection algorithm for highly alloimmunized patients. , 2001, Transplantation proceedings.

[16]  P W Nickerson,et al.  Class II HLA Epitope Matching—A Strategy to Minimize De Novo Donor‐Specific Antibody Development and Improve Outcomes , 2013, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[17]  Herton Luiz Alves Sales Filho,et al.  EpHLA software: a timesaving and accurate tool for improving identification of acceptable mismatches for clinical purposes. , 2012, Transplant immunology.

[18]  A. S. Silva,et al.  First report on the antibody verification of MICA epitopes recorded in the HLA epitope registry , 2014, International journal of immunogenetics.