NCM 2022: Potential rapid kidney graft allogenomics matching through nanopore sequencing
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Despite the refinement of HLA matching strategies, 40% of kidney allografts failed within 10 years of transplantation. The main cause is chronic graft rejection, an immune reaction mounted by the recipient (R) against the graft. Recent studies demonstrate that the entire genome, and not only the HLA locus, influences specifically the R’s immune response to the donor (D) graft. We published the allogenomics mismatch score (AMS) in 2016 to access risk of chronic graft loss from R with living donors. At that time, given technical constraints associated with sequencing technics we cannot evaluate with AMS the risk for any transplants. Nanopore give us the ability of gaining such information with versatility, rapidity of sequencing within the same assay producing HLA sequences for any type of kidney transplantation. We evaluate the ability of Nanopore sequencing with adaptive sampling to reach sufficient information for rapid AMS generation compared to standard methods (Exome sequencing, Illumina, Short read sequencing) we published.