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Personalized Peptide Arrays for Detection of HLA Alloantibodies in Organ Transplantation

Personalized Peptide Arrays for Detection of HLA Alloantibodies in Organ Transplantation

Published on: September 6, 2017

Selecting the best haploidentical donor.

Shannon R McCurdy¹, Ephraim J Fuchs¹

¹Johns Hopkins University, Baltimore, MD.

Seminars in Hematology

|October 30, 2016

Summary

This summary is machine-generated.

Human leukocyte antigen (HLA)-haploidentical blood or marrow transplantation is increasingly used. Donor selection for HLA-haploidentical transplants should prioritize factors beyond HLA match, including donor-specific antibodies and ABO compatibility.

Keywords:

Donor Selection Haploidentical Post-transplant cyclophosphamide

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Area of Science:

Immunology
Hematology
Transplantation Science

Background:

Human leukocyte antigen (HLA)-haploidentical (haplo) blood or marrow transplantation (BMT) is a viable option for patients lacking HLA-matched donors.
Increasing utilization of haplo BMT necessitates refined donor selection criteria beyond HLA matching.

Purpose of the Study:

To recommend a donor selection algorithm for HLA-haploidentical transplantation.
To identify critical factors for selecting the optimal haplo donor when HLA matching is not the sole determinant.

Main Methods:

Review of existing evidence on donor selection in HLA-haploidentical BMT.
Development of a proposed donor selection algorithm incorporating multiple donor characteristics.

Main Results:

A recommended algorithm prioritizes donor-specific antibodies, ABO compatibility, donor age, donor sex, and cytomegalovirus (CMV) serostatus match.
The algorithm aims to optimize donor selection when multiple suitable haplo donors are available.

Conclusions:

Factors beyond HLA matching are crucial for selecting the best donor in HLA-haploidentical BMT.
Further research is needed to evaluate the impact of HLA mismatches, NK cell alloreactivity, and non-inherited maternal HLA antigens on transplant outcomes.