The identification of MHC identical siblings without HLA typing

By comparing genomic sequences of different MHC haplotypes, we defined highly polymorphic markers. After amplification, electrophoresis, and scanning with a laser, we have identified profiles that serve as signatures of the haplotype and its component alleles. One set of markers can be used to define the block that includes HLA-B and HLA-C, among other loci. Another set provides signatures for the entire HLA-DR and -DQ multigene cluster. By profile overlay, it is possible to identify siblings who share both haplotypes from HLA-C to HLA-DQ. Here we demonstrate the value of genomic analysis ("block matching") in selecting genotypically identical siblings prior to transplantation. Forty-six siblings from 10 families were genotyped by family analysis after meticulous HLA, C4, and Bf typing including molecular methods for HLA-DRB1. In 43 siblings, the haplotype assignments were unequivocal. Twenty-two identical sibling pairs could then be compared with 77 nonidentical pairs. Independent genomic analysis yielded entirely concordant results. In three siblings, the possibility of parental recombination was considered but could not be defined by the conventional typing. By genomic analysis, however, it was clear that recombination had indeed occurred in one case. In the remaining two cases, additional, more telomeric markers will be necessary to resolve the issue. This simple, cost-effective method has immediate application to the identification of matched pairs (HLA-C to HLA-DQ) for bone marrow and renal transplantation.