期刊
HUMAN IMMUNOLOGY
卷 83, 期 10, 页码 665-673出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.humimm.2022.04.008
关键词
Hematopoietic Cell Transplant; Donor -speci fic HLA antibody; Virtual crossmatch; HLA Testing; Unrelated-donor
类别
This article provides a comprehensive and practical approach to HLA testing to support HCT and highlights donor selection considerations and available online tools.
Supporting allogeneic hematopoietic cell transplantation (HCT) is an integral function of the clinical HLA lab-oratory, which provides HLA testing for recipients and donors. However, the timing, scope, and methods of the HLA tests vary significantly in the field. This summary provides a comprehensive and practical HLA testing approach to maximize the efficiency of the donor search process, minimize donor-specific HLA antibody (DSA) associated risks, enable optimal donor selections, and support HCT multidisciplinary teams. This is not a comprehensive donor selection guide, but pertinent donor selection considerations and publicly available online selection tools are highlighted. In the absence of healthy HLA identical siblings, younger 8/8 (HLA-A,-B,-C,-DRB1) HLA-matched unrelated donors remain the most favorable choice for HCT. Emerging practices in preparative regimens and graft versus host disease (GvHD) prophylaxis as well as building evidence of the importance of other HLA (e.g., HLA-DPB1 allele and functional matching) and non-HLA (e.g., age, CMV, and KIR) donor attributes urge the transplant centers and the HLA laboratories to construct a comprehensive approach for the routine histocompatibility testing.
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