Disparities in minor histocompatibility antigens between HLA-matched o
rgan and bone marrow donors and recipients create a potential risk for
graft failure and graft-versus-host disease. These conditions necessi
tate lifelong pharmacological immunosuppression of organ and bone marr
ow transplant recipients. Recent technical advances have resulted in t
he identification of the chemical nature of the first human minor hist
ocompatibility antigens. A new era of research has begun to provide in
sights into the genetics of minor antigens and their putative role in
transplantation.