title: Noninherited maternal antigens identify acceptable HLA mismatches: benefit to patients and cost-effectiveness for cord blood banks.
abstract: Cord blood unit (CBU) transplantations to patients mismatched for only 1 HLA antigen, which is identical to the CBU noninherited maternal antigen (NIMA), are designated as having a 6/6 "virtual" NIMA-matched phenotype and have a prognosis similar to 6/6 inherited HLA-matched CBUs. Such virtual HLA phenotypes of CBUs can be created by replacing the inherited alleles with 1 or more NIMAs. Phenotypes of Dutch patients (n = 2020) were matched against the inherited and virtual HLA phenotypes of the National Cord Blood Program CBU file (with known NIMA, n = 6827). Inherited 6/6 matches were found for 11% of the patients. Including virtual phenotypes resulted in, overall, 19-fold more different phenotypes than were inherited, conferring 6/6 virtual matches for an additional 20% of the patients, whereas another 17% might benefit from CBUs with a 4/6 HLA match and 1 NIMA match (4/6 + 1NIMA or 5/6 virtual match). The elucidation of donors' maternal HLA phenotypes can provide significant numbers of 6/6 and 5/6 virtually matched CBUs to patients and is potentially cost effective.
authors.affiliation: Europdonor Foundation, Leiden, Netherlands. Electronic address: zanden@europdonor.nl.
authors.forename: Henk G M
authors.initials: HG
authors.lastname: Van der Zanden
authors.affiliation: Europdonor Foundation, Leiden, Netherlands; Department of Immunohematology and Blood Transfusion, Leiden University Medical Centre, Leiden, Netherlands.
authors.forename: Jon J
authors.initials: JJ
authors.lastname: Van Rood
authors.affiliation: Europdonor Foundation, Leiden, Netherlands; Department of Immunohematology and Blood Transfusion, Leiden University Medical Centre, Leiden, Netherlands.
authors.forename: Machteld
authors.initials: M
authors.lastname: Oudshoorn
authors.affiliation: Europdonor Foundation, Leiden, Netherlands.
authors.forename: Jack N A
authors.initials: JN
authors.lastname: Bakker
authors.affiliation: Europdonor Foundation, Leiden, Netherlands.
authors.forename: Angelo
authors.initials: A
authors.lastname: Melis
authors.affiliation: Europdonor Foundation, Leiden, Netherlands; Department of Immunohematology and Blood Transfusion, Leiden University Medical Centre, Leiden, Netherlands.
authors.forename: Anneke
authors.initials: A
authors.lastname: Brand
authors.affiliation: National Cord Blood Program, Howard P. Milstein Cord Blood Center, New York Blood Center, New York.
authors.forename: Andromachi
authors.initials: A
authors.lastname: Scaradavou
authors.affiliation: National Cord Blood Program, Howard P. Milstein Cord Blood Center, New York Blood Center, New York.
authors.forename: Pablo
authors.initials: P
authors.lastname: Rubinstein
mesh_terms: D000906:Antibodies / Q000276:immunology*; D001771:Blood Banks / Q000191:economics*; D005260:Female; D005312:Fetal Blood / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D014019:Tissue Donors
chemical_list: D000906:Antibodies; D006680:HLA Antigens
keywords: Acceptable; Cord; Mismatches; Noninherited maternal antigen; Transplantation