A special report: Histocompatibility testing guidelines for hematopoietic stem cell transplantation using volunteer donors

The World Marrow Donor Association has formulated guidelines for establishi ng the extent and quality of histocompatibility testing for unrelated donor registries, umbilical cord blood banks, and transplant centers involved in international exchange of hematopoietic stem cells for allogeneic transpla ntation. Registry and cord blood bank guidelines suggest that, at a minimum , initial HLA typing should be performed for three HLA loci, HLA-A, -B, and -DR, at low resolution/split antigen level. DNA-based testing methods shou ld be utilized for HLA-DR typing. DNA-based resting for HLA-A and -B should replace serologic testing of new volunteer donors and cord blood units as robust protocols and reagents become available to the laboratories. Transpl ant center guidelines for typing of patient, family and to confirm the HLA types of potential unrelated donors should include, at the minimum, typing HLA-A, B, and -DR loci using primarily DNA-based testing methods at allele level resolution for DRB1 and low resolution/split antigen level for HLA-A and -B. it is strongly recommended that the typing of a patient and the sel ected donor be performed using the same set of reagents, methodology, and i nterpretation criteria with fresh tissue samples to ensure HLA identity. Gu idelines for laboratory accreditation, approaches to quality assurance and quality control for HLA testing, and suggestions for the format of the HLA database of donor types are also outlined. Human Immunology 60, 347-360 (19 99). (C) World Marrow Donor Association, 1998. Published by Elsevier Scienc e Inc.