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Current HLA testing recommendations to support HCT.

Neng Yu1, Medhat Askar2, Kim Wadsworth3

  • 1UMass Chan Medical School, Worcester, MA 01605, USA.

Human Immunology
|July 7, 2022
PubMed
Summary
This summary is machine-generated.

Clinical HLA testing is crucial for hematopoietic cell transplantation (HCT). This summary outlines a practical HLA testing approach to optimize donor selection and minimize risks, enhancing HCT outcomes.

Keywords:
Donor-specific HLA antibodyHLA TestingHematopoietic Cell TransplantUnrelated-donorVirtual crossmatch

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Area of Science:

  • Immunogenetics
  • Transplantation Immunology
  • Clinical Laboratory Science

Background:

  • Allogeneic hematopoietic cell transplantation (HCT) relies heavily on clinical HLA laboratory testing for donor and recipient compatibility.
  • Current HLA testing protocols for HCT vary significantly in timing, scope, and methodology.
  • Optimizing HLA testing is essential for successful HCT outcomes and patient safety.

Purpose of the Study:

  • To propose a comprehensive and practical HLA testing strategy for HCT.
  • To enhance the efficiency of the donor search process.
  • To minimize risks associated with donor-specific HLA antibodies (DSA) and support HCT multidisciplinary teams.

Main Methods:

  • Review of current practices in HLA testing for HCT.
  • Highlighting pertinent donor selection considerations.
  • Discussion of publicly available online donor selection tools.

Main Results:

  • In the absence of HLA-identical siblings, younger 8/8 HLA-matched unrelated donors are the most favorable option for HCT.
  • Emerging evidence emphasizes the importance of HLA-DPB1 allele and functional matching.
  • Non-HLA factors like age, CMV status, and KIR genotypes are increasingly recognized as critical.

Conclusions:

  • A comprehensive approach to routine histocompatibility testing is urged for transplant centers and HLA laboratories.
  • Integrating HLA and non-HLA factors into donor selection is crucial for optimizing HCT.
  • Standardized and advanced HLA testing protocols can improve HCT success rates.