The role of HLA-typing in transplantation of hematopoietic stem cells

Abstract

The system of human leukocyte antigen (HLA) and HLA-typing were used to match a potential donor with a recipient for allogeneic hematopoietic stem cell transplantation (HSCT). The HLA matching between donor and recipient is key role in allogeneic HSCT. The mismatch of HLA can cause graft rejection, graft-versus-host disease and decrease survival in patients receiving grafts from both related and unrelated donors. The adverse HLA effect on the outcome depends on the total number of mismatched alleles/loci and the resolution level of the mismatch (antigen or allele level).Thus, the final choice of compatible donor-recipient pairs should be based on high resolution molecular-genetic methods of HLA-typing. Serologic and molecular genetic methods of low resolution HLA-typing, which are cheaper than HLA-typing high-resolution, should be used for donor screening studies. HSCT from a fully compatible donor, matched high-resolution HLA-typing methods gives better results than from partially compatible. In some clinical circumstances, a partially compatible donor may be as effective as fully compatible. The selection of such a donor, taking into account the controversy of data from various literary sources, should be based on own research and experience. Creation and development of a Ukrainian database of donors with the HLA-haplotype specific to the indigenous population will make search of matching pairs of donor recipients more effective and cost-effective.