HLA matching in hematopoietic cell transplantation

Progress in hematopoietic cell transplantation has been greatly facilitated by our increasing knowledge of the HLA system. as well as by improved ther apies for achieving sustained engraftment, preventing graft-versus-host dis ease, and protecting the patient from infection. Disparity for HLA genes ca n cause graft rejection and graft-versus-host disease and decrease survival in patients receiving grafts from both related and unrelated donors. The p resence of patient alloantibodies against donor antigens demonstrated by a positive crossmatch is a strong risk factor for graft rejection. The availa bility of matched donors for patients lacking a genotypically HLA-matched s ibling has been greatly improved by the establishment of international regi stries of HLA-typed volunteer donors. The development of accurate and repro ducible high-resolution DNA-based. typing methods has significantly improve d the prospects for identifying unrelated donors who are well matched with the patient for HLA. The use of these methods to optimize donor selection w ill improve both donor identification and the success of unrelated donor tr ansplants. Human Immunology 61, 92-100 (2000). (C) American Society for com patibility and Immunogenetics, 2000. Published by Elsevier Science Inc.