title: A special report: histocompatibility testing guidelines for hematopoietic stem cell transplantation using volunteer donors. Quality Assurance and Donor Registries Working Groups of the World Marrow Donor Association.
abstract: The World Marrow Donor Association has formulated guidelines for establishing 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 transplantation. 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 should be utilized for HLA-DR typing. DNA-based testing 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. Transplant 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 selected donor be performed using the same set of reagents, methodology, and interpretation criteria with fresh tissue samples to ensure HLA identity. Guidelines 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.
authors.affiliation: Department of Microbiology and Immunology, Georgetown University Medical School, Washington, DC, USA. hurleyc@gunet.georgetown.edu
authors.forename: C K
authors.initials: CK
authors.lastname: Hurley
authors.forename: J A
authors.initials: JA
authors.lastname: Wade
authors.forename: M
authors.initials: M
authors.lastname: Oudshoorn
authors.forename: D
authors.initials: D
authors.lastname: Middleton
authors.forename: D
authors.initials: D
authors.lastname: Kukuruga
authors.forename: C
authors.initials: C
authors.lastname: Navarrete
authors.forename: F
authors.initials: F
authors.lastname: Christiansen
authors.forename: J
authors.initials: J
authors.lastname: Hegland
authors.forename: E C
authors.initials: EC
authors.lastname: Ren
authors.forename: I
authors.initials: I
authors.lastname: Andersen
authors.forename: S A
authors.initials: SA
authors.lastname: Cleaver
authors.forename: C
authors.initials: C
authors.lastname: Brautbar
authors.forename: C
authors.initials: C
authors.lastname: Raffoux
mesh_terms: D016026:Bone Marrow Transplantation / Q000379:methods / Q000592:standards; D005312:Fetal Blood / Q000276:immunology; D005819:Genetic Markers; D006680:HLA Antigens / Q000235:genetics; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000592:standards*; D006650:Histocompatibility Testing / Q000379:methods* / Q000592:standards*; D006782:Hospitals, Special; D006801:Humans; D007755:Laboratories, Hospital / Q000592:standards; D008499:Medical Records / Q000592:standards; D009679:Nuclear Family; D011785:Quality Assurance, Health Care; D012042:Registries; D015203:Reproducibility of Results; D013997:Time Factors; D014019:Tissue Donors; D014838:Volunteers; D014944:World Health Organization
chemical_list: D005819:Genetic Markers; D006680:HLA Antigens