A browser-based HLA epitope (mis)matching application in sensitizing events of transplantation and transfusion: epiTOol

Handling large numbers of transplant donors and recipients" data in diagnostics is often still a manual transfer process and a source for potentially fatal mishap. Moreover, allele matching, processing of antibody data, and epitope assignment requires separate tools with partially missing direct interfaces.

Here we present "epiTOol", an interactive analytics tool for all-in-one processing of HLA typing and antibody data. At first, data import functionalities create a database of individuals collecting HLA typing and antibody data. Large numbers of several thousand or tens of thousands of measurements can be loaded simultaneously. For the individually present alleles and antibodies, epitopes are then automatically assigned using incorporated data previously extracted from epregistry.com.br.

Based on these epitopes, matches and mismatches between the recipient-donor pairs can be assessed. Thereby, two modes are available: a) Single individual mode: Comparison of a single donor to a list of potential recipients (i.e. one available organ to a waiting list of patients), or, vice versa, a single patient to a list of potential donors. b) Pair mode: Pairwise comparison of donors and assigned recipients. Both modes can be applied in the daily diagnostic tasks in immunology laboratories as well as for scientific retrospective evaluation. Matching and mismatching epitopes are displayed for each comparison by means of absolute numbers and of present allele, antibody and epitope information, respectively. Finally, export functionalities for spreadsheet and pdf files allow for easy and comfortable utilization of the evaluation results in routine processes such as issuing medical reports.

As a proof of principle screening of a test cohort of 108 recipient-donor pairs led to first results, regarding epitope match and mismatch constellation, prevalence, and antibody production.

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