Generation of the Histocompatibility Map report. Preparation of CSV files is related to transferring CSV files to the input directory of the EpHLA program’s directory tree. The CSV files copied to the input directory are shown in the form Available CSV files in directory ( Fig. 1, [B]). Using this form, one or more files can be selected and processed (workflow’s second step). The EpHLA software uses information available in the HLAMatchmaker program’s spreadsheets ( [5]http://www.hlamatchmaker.net), including class of HLA and lot number of SPA kits (obtained from the PD0325901 in vitro manufacturer — Fig. 1, [C]). The result of the processing is available in the EpHLA

— Local repository form. This form contains information on the recipient and his/her SPA results. Thus, one must access the Local repository form of the EpHLA software and type in the class I and class II HLA alleles of the recipient and donor. The next step is to determine the cutoff value. The standard value of the EpHLA

program is 500 of Median-Fluorescence Intensity (MFI). However, the laboratory personnel can define the value or alter to the suggested value in section Calculated Cutoff, according to Rene Duquesnoy [16] ( Fig. 2). In the last step, the EpHLA program executes the HLAMatchmaker algorithm to generate the Histocompatibility Map report. During this step, the recipient’s eplets of the self HLA molecules are removed from the histocompatibility analysis; Metabolism inhibitor the remaining eplets (non-self) are shown in the Histocompatibility Map report and classified by the EpHLA program as potentially or weakly immunogenic based on the adopted MFI cutoff value. All alleles of the panel whose MFI is lower than the cutoff established by the laboratory personnel will have its eplets classified as weakly immunogenic in all HLA molecules studied.

These eplets are shown in blue. Otherwise, the eplet is considered potentially immunogenic and is typed black or red. A black eplet means that it is not the only eplet responsible for immunogenicity Branched chain aminotransferase of the HLA molecule. On the other hand, a red eplet stands for a unique eplet responsible for immunogenicity in at least one HLA molecule for the tested serum whose MFI value is larger than the cutoff. The Histocompatibility Map report from the EpHLA program contains two tabsheets: (i) Eplets Map and (ii) Eplet’s Report. Eplets Map contains five predictable tabs groupings: Acceptable Mismatches, No Mismatches, Recipient × Donor, Unacceptable Mismatches and All Mismatches (Fig. 3). These tabs allow the laboratory personnel to visualize, to order and to group HLA alleles so as to improve the histocompatibility study of the recipient/donor pair. The Recipient × Donor tab shows the donor’s HLA antigens and his/her eplets easing the immunological risk definition associated to the recipient/donor pair in the study.