Davis S, Wiebe C, Campbell K, et al. - Researchers aimed at determining the value of human leukocyte antigen (HLA)‐DR/DQ molecular mismatch in predicting de novo donor‐specific antibodies (DSAs) during the first year of transplantation among renal transplant patients. Further, they examined how differences in tacrolimus exposure may affect this risk. Among 444 donor‐recipient pairs in Denver, Colorado between 2007 and 2013, they determined HLA‐DR and ‐DQ eplet mismatches. Recipients were stratified based on previously defined mismatch thresholds into low‐ (N = 119), intermediate‐ (N = 153), and high‐ (N = 172) risk categories. Compared to low‐risk patients, intermediate and high‐risk categories showed a graded increase in risk of DR/DQ DSA. They noted increased risk of DR/DQ DSA at 1 year among intermediate‐ and high‐risk patients with a mean tacrolimus < 6 ng/ml vs > 8 ng/ml. These findings suggest HLA molecular mismatch to be a reproducible, objective, and clinically relevant tool to stratify cases by alloimmune risk and may aid in guiding personalized immunosuppression management.