Combined Molecular Mismatch Approaches to Predict Immunological Events Within the First Year After Renal Transplantation

·  Study evaluates three molecular mismatch metrics—eplet mismatchcount, highly immunogenic eplets, and PIRCHE-II score—to classify renaltransplant rejection risk.

·  Low- and high-risk groups were defined basedon whether all scores were below or above certain cut-offs.

·  One-year rejection incidence was 12% in thelow-risk group and 33% in the high-risk group, showing a significantdifference.

·  Internal validation confirmed the model’saccuracy in predicting clinical rejection, ATG-treated rejection, and de novoHLA-DSA.

·  Findings suggest combining these molecularapproaches effectively stratifies rejection risk in standard renal transplantpatients.