ETRL publications

The ETRL performs research to provide the scientific evidence required for new policies and recommendations regarding histocompatibility within Eurotransplant. This research is being published in well-recognised international peer-reviewed journals. Below is a list of work published by the ETRL.


  1. Suzanne Bezstarosti, Cynthia S.M. Kramer, Frans H.J. Claas, Hans W. de Fijter, Marlies E.J. Reinders, Sebastiaan Heidt: Implementation of molecular matching in transplantation requires further characterization of both immunogenicity and antigenicity of individual HLA epitopes. Human Immunology, 2022; 83(3): 256-263
  2. Suzanne Bezstarosti, Kim H. Bakker, Cynthia C.M. Kramer, Hans W. de Fijter, Marlies E.J. Reinders, Arend Mulder, Frans H.J. Claas, Sebastiaan Heidt: A comprehensive evaluation of the antibody-verified status of eplets listed in the HLA Epitope Registry. Frontiers in Immunology, 2022; 12
  3. 2021

  4. Sebastiaan Heidt, Geert W. Haasnoot, Marissa J. H. Linden-van Oevelen, Frans H.J. Claas: Highly Sensitized Patients Are Well Served by Receiving a Compatible Organ Offer Based on Acceptable Mismatches. Frontiers in Immunology, 2021; 12
  5. Suzanne Bezstarosti, Cynthia S.M. Kramer, Marry E.I. Franke-van Dijk, Manon Vergunst, Kim H. Bakker, Merve Uyar-Mercankaya, Rico Buchli, Dave L. Roelen, Hans W. de Fijter, Frans H.J. Claas, Sebastiaan Heidt: HLA-DQ-specific recombinant human monoclonal antibodies allow for in-depth analysis of HLA-DQ epitopes. Frontiers in Immunology, 2021; 12
  6. 2020

  7. Cynthia S. M. Kramer, Johan Koster, Geert W. Haasnoot, Dave L. Roelen, Frans H. J. Claas, Sebastiaan Heidt: HLA-EMMA: a user-friendly tool to analyse HLA class I and class II compatibility on the amino acid level. HLA, 2020; 96(1): 43-51
  8. Frans H.J. Claas, Sebastiaan Heidt: Virtual crossmatching for deceased donor transplantation becomes reality. Kidney International, 2020; 97(4): 657-659
  9. Sebastiaan Heidt, Frans H.J. Claas: Not all HLA epitope mismatches are equal. Kidney International, 2020; 97(4): 653-655
  10. Cynthia S. M. Kramer, Marry E. I. Franke-van Dijk, Kim H. Bakker, Merve Uyar-Mercankaya, Gonca E. Karahan, Dave L. Roelen, Frans H. J. Claas, Sebastiaan Heidt: Generation and reactivity analysis of human recombinant monoclonal antibodies directed against epitopes on HLA-DR. American Journal of Transplantation, 2020;
  11. Lisa Mumford, Susan V. Fuggle, Jaume Martorell, Antonij Slavcev, Aliki Iniotaki, Geert W. Haasnoot, Sebastiaan Heidt, Frans H.J. Claas: A Europe wide acceptable mismatch program will enable transplantation of long waiting highly sensitised patients with a compatible donor. Transplant Immunology, 2020; 64
  12. 2019

  13. Sebastiaan Heidt, Geert W. Haasnoot, Marian D. Witvliet, Marissa J. H. Linden-van Oevelen, Elena G. Kamburova, Bram W. Wisse, Irma Joosten, Wil A. Allebes, Arnold Meer, Luuk B. Hilbrands, Marije C. Baas, Eric Spierings, Cornelis E. Hack, Franka E. Reekum, Arjan D. Zuilen, Marianne C. Verhaar, Michiel L. Bots, Adriaan C. A. D. Drop, Loes Plaisier, Marc A. J. Seelen, Jan-Stephan Sanders: Allocation to highly sensitized patients based on acceptable mismatches results in low rejection rates comparable to nonsensitized patients. American Journal of Transplantation, 2019; 19(10): 2926-2933
  14. Mian Chen, Yvonne Zoet, Dave Roelen, Jaume Martorell, Derek Middleton, Antonij Slavcev, Aliki Iniotaki, Frans Claas, Susan Fuggle: Towards uniformity in the definition of acceptable mismatches for highly sensitized patients. HLA, 2019; 94(2): 147-153
  15. Cynthia S.M. Kramer, Moshe Israeli, Arend Mulder, Ilias I.N. Doxiadis, Geert W. Haasnoot, Sebastiaan Heidt, Frans H.J. Claas: The long and winding road towards epitope matching in clinical transplantation. Transplant International, 2019; 32(1): 16-24
  16. Cynthia Kramer, Sebastiaan Heidt, Frans H.J. Claas: Towards the identification of the relative immunogenicity of individual HLA antibody epitopes. Human Immunology, 2019; 80(4): 218-220
  17. Kramer, C. S. M., Franke-van Dijk, M. E. I., Priddey, A. J., Pongracz, T., Gnudi, E., Car, H., Karahan, G. E., van Beelen, E., Zilvold-van den Oever, C. C. C., Rademaker, H. J., de Haan, N., Wuhrer, M., Kosmoliaptsis, V., Parren, P. W. H. I., Mulder, A., Roelen, D. L., Claas, F. H. J., Heidt, S.: Recombinant human monoclonal HLA antibodies of different IgG subclasses recognising the same epitope: Excellent tools to study differential effects of donor-specific antibodies. HLA, 2019; 94(5): 415-424
  18. 2018

  19. Sebastiaan Heidt, Geert W. Haasnoot, Jon J. van Rood, Marian D. Witvliet, Frans H.J. Claas: Kidney allocation based on proven acceptable antigens results in superior graft survival in highly sensitized patients. Kidney International, 2018; 93(2): 491-500
  20. Sebastiaan Heidt, Geert W. Haasnoot, Frans H.J. Claas: How the definition of acceptable antigens and epitope analysis can facilitate transplantation of highly sensitized patients with excellent long-term graft survival. Current Opinion in Organ Transplantation, 2018; 23(4): 493-499
  21. Sebastiaan Heidt, Frans H.J. Claas: Transplantation in highly sensitized patients: challenges and recommendations. Expert Review of Clinical Immunology, 2018; 14(8): 673-679
  22. 2017

  23. Frans H.J. Claas, Sebastiaan Heidt: Epitope-Based HLA Matching: A Useful Strategy With Many Shortcomings to Overcome. Transplantation, 2017; 101(8): 1744-1745
  24. C. S. M. Kramer, D. L. Roelen, S. Heidt, F. H. J. Claas: Defining the immunogenicity and antigenicity of HLA epitopes is crucial for optimal epitope matching in clinical renal transplantation. HLA, 2017; 90(1): 5-16
  25. 2015

  26. Sebastiaan Heidt, Marian D. Witvliet, Geert W. Haasnoot, Frans H.J. Claas: The 25th anniversary of the Eurotransplant Acceptable Mismatch program for highly sensitized patients. Transplant Immunology, 2015; 3351-57
  27. 2011

  28. Y. M. Zoet, S. H. Brand-Schaaf, D. L. Roelen, A. Mulder, F. H. J. Claas, I. I. N. Doxiadis: Challenging the golden standard in defining donor-specific antibodies: does the solid phase assay meet the expectations?. Tissue Antigens, 2011; 77(3): 225-228
  29. 2010

  30. Ilias IN Doxiadis, Dave Roelen, Frans HJ Claas: Mature wines are better: CDC as the leading method to define highly sensitized patients. Current Opinion in Organ Transplantation, 2010; 15(6): 716-719
  31. Doxiadis,, II, Rahmel, A., Claas, F. H.: Towards kidney allocation on basis of HLA-DR compatibility. Clin Transpl, 2010; 61-64
  32. Frans HJ Claas: Clinical relevance of circulating donor-specific {HLA. Current Opinion in Organ Transplantation, 2010; 15(4): 462-466
  33. 2009

  34. Frans HJ Claas, Ilias IN Doxiadis: Management of the highly sensitized patient. Current Opinion in Immunology, 2009; 21(5): 569-572
  35. Ilias IN Doxiadis, Frans HJ Claas: Transplantation of highly sensitized patients via the acceptable mismatch program or desensitization? We need both. Current Opinion in Organ Transplantation, 2009; 14(4): 410-413
  36. Frans H. J. Claas, Axel Rahmel, IIias I. N. Doxiadis: Enhanced Kidney Allocation to Highly Sensitized Patients by the Acceptable Mismatch Program. Transplantation, 2009; 88(4): 447-452
  37. 2008

  38. Frans H. J. Claas: HLA antibody testing: a tool to facilitate not to prevent organ transplantation. International Journal of Immunogenetics, 2008; 35(4): 275-277
  39. 2007

  40. C. Eijsink, Y. M. Zoet, M. J. Kardol, M. D. Witvliet, F. H. J. Claas, A. Mulder, I. I. N. Doxiadis: Identification of acceptable {HLA. Tissue Antigens, 2007; 69(4): 354-357
  41. Ilias I. N. Doxiadis, Johan W. de Fijter, Marko J. K. Mallat, Geert W. Haasnoot, Jan Ringers, Guido G. Persijn, Frans H. J. Claas: Simpler and equitable allocation of kidneys from postmortem donors primarily based on full HLA-DR compatibility. Transplantation, 2007; 83(9): 1207-1213
  42. 2006

  43. Frans H.J. Claas, Dave L. Roelen, Arend Mulder, Ilias I.N. Doxiadis, Machteld Oudshoorn, Martin Heemskerk: Differential immunogenicity of HLA class I alloantigens for the humoral versus the cellular immune response: towards tailor-made HLA mismatching. Human Immunology, 2006; 67(6): 424-429
  44. Ilias I. N. Doxiadis, Frans H. J. Claas: Donor-Specific Antibodies Arising after Kidney Transplantectomy: Priming or Memory?. Transplantation, 2006; 81(4): 509-510
  45. 2005

  46. Ilias IN Doxiadis, Rene J Duquesnoy, Frans HJ Claas: Extending options for highly sensitized patients to receive a suitable kidney graft. Current Opinion in Immunology, 2005; 17(5): 536-540
  47. Frans H.J. Claas, Marlies K. Dankers, Machteld Oudshoorn, Jon J. van Rood, Arend Mulder, Dave L. Roelen, Rene J. Duquesnoy, Ilias I.N. Doxiadis: Differential immunogenicity of HLA mismatches in clinical transplantation. Transplant Immunology, 2005; 14(3): 187-191
  48. Yvonne M. Zoet, Chantal Eijsink, Marrie J. Kardol, Marry E.I. Franke-van Dijk, G. Louis Wilson, Roel de Paus, Eric Mickelson, Mirjam Heemskerk, Peter J. van den Elsen, Frans H.J. Claas, Arend Mulder, Ilias I.N. Doxiadis: The single antigen expressing lines (SALs) concept: an excellent tool for screening for HLA-specific antibodies. Human Immunology, 2005; 66(5): 519-525
  49. Frans HJ Claas: Transplantation: changing dogmas in clinical transplantation immunology. Current Opinion in Immunology, 2005; 17(5): 533-535
  50. Yvonne M. Zoet, Chantal Eijsink, Radka Bohmova, Marian D. Witvliet, Marrie J. Kardol, Marry E. I. Franke, Frans H. J. Claas, Arend Mulder, Ilias I. N. Doxiadis: Single-Antigen-Expressing Cell Lines Are Excellent Tools for Detecting Human Leukocyte Antigen-C???Reactive Antibodies in Kidney Transplant Recipients. Transplantation, 2005; 79(9): 1268-1272
  51. 2004

  52. Ilias I. N. Doxiadis, Jacqueline M. A. Smits, Guido G. Persijn, Ulrich Frei, Frans H. J. Claas: It takes six to boogie: Allocating cadaver kidneys in eurotransplant. Transplantation, 2004; 77(4): 615-617
  53. Frans H. J. Claas, Marian D. Witvliet, Rene Duquesnoy, Guido G. Persijn, Ilias I. N. Doxiadis: The Acceptable Mismatch Program as a Fast Tool for Highly Sensitized Patients Awaiting a Cadaveric Kidney Transplantation: Short Waiting Time and Excellent Graft Outcome. Transplantation Journal, 2004; 78(2): 190-193
  54. Marlies K.A Dankers, Dave L Roelen, Nico J.D Nagelkerke, Peter de Lange, Guido G Persijn, Ilias I.N Doxiadis, Frans H.J Claas: The HLA-DR phenotype of the responder is predictive of humoral response against HLA class I antigens. Human Immunology, 2004; 65(1): 13-19
  55. Marlies K. A. Dankers, Marian D. Witvliet, Dave L. Roelen, Peter De Lange, Nelleke Korfage, Guido G. Persijn, Ren{\'{e: The number of amino acid triplet differences between patient and donor is predictive for the antibody reactivity against mismatched human leukocyte antigens. Transplantation, 2004; 77(8): 1236-1239
  56. 2003

  57. Marlies K.A. Dankers, Dave L. Roelen, Ellen M.W. van der Meer-Prins, Peter de Lange, Nelleke Korfage, Jacqueline M.A. Smits, Guido G. Persijn, Ken I. Welsh, Ilias I.N. Doxiadis, Frans H.J. Claas: Differential immunogenicity of HLA mismatches: HLA-A2 versus HLA-A28. Transplantation, 2003; 75(3): 418-420
  58. Doxiadis,, II, Persijn, G. G., Claas, F. H.: The crossmatch policy of the transplantation center influences graft survival in cadaver kidney transplantation. Clin Transpl, 2003; 143-147
  59. 2000

  60. Doxiadis,, II, Witvliet, M., Verduyn, W., de Lange, P., Tanke, J., Schreuder, G. M., Persijn, G. G., Claas, F. H.: The relevance of proficiency testing for laboratories involved in cadaveric organ transplantation and its consequences for graft survival. Clin Transpl, 2000; 99-103
  61. 1999

  62. Claas, F. H., De Meester, J., Witvliet, M. D., Smits, J. M., Persijn, G. G., Doxiadis,, II: Acceptable HLA mismatches for highly immunized patients. Rev Immunogenet, 1999; 1(3): 351-358
  63. 1996

  64. Ilias IN Doxiadis, Jacqueline MA Smits, Geziena M Th Schreuder, Guido G Persijn, Hans C van Houwelingen, Jon J van Rood, Frans HJ Claas: Association between specific HLA combinations and probability of kidney allograft loss: the taboo concept. The Lancet, 1996; 348(1931): 850-853
  65. 1989

  66. F. H. J. Claas, A. van Leeuwen, J. J. van Rood: Hyperimmunized patients do not need to wait for an HLA identical donor. Tissue Antigens, 1989; 34(10): 23-29
  67. Claas, F. H., van Rood, J. J.: Transplantation in hyperimmunized patients. Adv Nephrol Necker Hosp, 1989; 18317-323
  68. Frans H.J. Claas, Gijbels, Y., von Veen, A., de Waal, L. P., DAmaro, J., Persijn, G. G., van Rood, J. J.: Selection of cross-match negative HLA-A and/or -B mismatched donors for highly sensitized patients. Transplantation Proceedings, 1989; 21(1): 665-666
  69. Frans H.J. Claas, de Waal, L. P., Beelen, J., Reekers, P., Berg-Loonen, P. V., de Gast, E., DAmaro, J., Persijn, G. G., Zantvoort, F., van Rood, J. J.: Transplantation of highly sensitized patients on the basis of acceptable HLA-A and B mismatches. Clin Transpl, 1989; 185-190
  70. 1988

  71. F. Claas, Y Gijbels, J van der Velden-de Munck, J. van Rood: Induction of B cell unresponsiveness to noninherited maternal HLA antigens during fetal life. Science, 1988; 241(4874): 1815-1817
  72. Frans H. J. Claas, Jon J. Rood: The hyperimmunized patient: from sensitization toward transplantation. Transplant International, 1988; 1(2): 53-57
  73. Claas, F. H., Gijbels, Y., van der Velden-de Munck, J. J., de Waal, L. P., DAmaro, J., Hendriks, G. F., Persijn, G. G., van Rood, J. J.: A special strategy to increase the chance of finding cross-match negative kidneys for highly sensitized patients. Transplantation Proceedings, 1988; 20(5): 947-948
  74. 1986

  75. Schreuder, G. M., Hendriks, G. F., DAmaro, J., Persijn, G. G.: An eight-year study of HLA typing proficiency in Eurotransplant. Tissue Antigens, 1986; 27(3): 131-141
  76. 1985

  77. Hendriks, G. F., de Lange, P., DAmaro, J., Schreuder, G. M., Claas, F. H., Persijn, G. G., van Rood, J. J.: Eurotransplant experience with highly immunized patients. Scand J Urol Nephrol Suppl, 1985; 9281-86