Population-agnostic real-time molecular mismatch estimation using rSSO-defined HLA allele strings: minimal impact of allelic discordance with NGS

The first allele listed in the rSSO-derived MAC string provides a reliable, population-agnostic surrogate for high-resolution HLA typing in molecular mismatch assessment. Although allele-level discordance occurs, it rarely results in clinically meaningful increases in eplet mismatch burden. This laboratory-based approach enables real-time molecular mismatch estimation in time-sensitive settings and facilitates retrospective analysis of cohorts lacking sequencing-based HLA data, supporting broader integration of molecular mismatch into precision transplantation practice.