Reindl-Schwaighofer R, et al. - In a Cox proportional hazard model, adjusting for HLA mismatch and clinical covariates, researchers evaluated the relationship between non-synonymous single nucleotide polymorphism (nsSNP) mismatch and graft loss. In order to identify incompatibilities in transmembrane and secreted proteins, genome-wide genetic mismatches in nsSNPs were calculated. Between December 1, 2005, and April 30, 2015, they genotyped 477 pairs of deceased donors and first kidney transplant recipients with stable graft function at three months that were transplanted. Findings suggested an association of genetic mismatch of non-HLA haplotypes coding for transmembrane or secreted proteins with an increased risk of functional graft loss independently of HLA incompatibility. As in HLA alloimmunity, it is possible to identify donor-specific alloantibodies against non-HLA epitopes derived from genotypes.