title: Does high-resolution donor typing of HLA-C or other loci upon registration confer advantages to patients?
abstract: Our study compared all requests for confirmatory typing (CT requests) received in our center between May 2007 and December 2009 (n = 134) for donors issued from 3 groups defined by different human leukocyte antigen (HLA) loci typed at different levels of resolution. We observed a significant advantage for volunteers when HLA-C 2-digit typing was available or with HLA-A, -B, -C, -DRB1 4-digit typing compared with generic HLA-A, -B, -DRB1, -DQB1 DNA typing: increased percentage of CT requests (p < 0.001), increased rate of donor selection for donation (p < 0.001), and decreased time frame for donor search (p = 0.025). The time frame for a successful search (donation) is similar among the 3 groups, indicating that the search might be concluded more rapidly when the pathology is clinically active or when the patient is at a high risk of relapse (76% of our cases) or for pediatric patients (24% of our cases), regardless of HLA typing resolution. Improvement of HLA typing for volunteers could be a great advantage for first selection in the absence of emergency or high-risk disease. Knowledge of HLA-C should be used to prioritize the selection of donors for further testing and could allow a better donor selection process, reducing search duration and increasing efficiency. In most cases, 2-digit typing for HLA-C associated with specific tools to estimate the probability of finding a matched donor could be sufficient.
authors.affiliation: Department of Histocompatibility, EFS Rhône Alpes, 69007 Lyon, France. valerie.dubois@efs.sante.fr
authors.forename: Valerie
authors.initials: V
authors.lastname: Dubois
authors.forename: Catherine
authors.initials: C
authors.lastname: Giannoli
authors.forename: Marie Lorraine
authors.initials: ML
authors.lastname: Balère
authors.forename: Sylvie
authors.initials: S
authors.lastname: Rey
authors.forename: Colette
authors.initials: C
authors.lastname: Raffoux
authors.forename: Dominique
authors.initials: D
authors.lastname: Rigal
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D018450:Disease Progression; D046148:Donor Selection / Q000379:methods / Q000592:standards; D005602:France; D015236:HLA-C Antigens / Q000235:genetics*; D006239:Haplotypes; D006648:Histocompatibility / Q000235:genetics / Q000276:immunology; D006650:Histocompatibility Testing / Q000379:methods / Q000592:standards; D006801:Humans; D015810:Linkage Disequilibrium; D012042:Registries; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D015236:HLA-C Antigens