Vol 3, No 3 (2012)
Review paper
Published online: 2012-10-10

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Immunogenetic donor-recipient matching for allogeneic stem cell transplantation

Anna Marosz-Rudnicka, Renata Mika-Witkowska, Elżbieta Graczyk-Pol, Agnieszka Długokęcka, Marta Rogatko-Koroś, Jacek Nowak
Hematologia 2012;3(3):211-220.

Abstract

Allogeneic hematopoietic stem cell transplantation is dependent on successful search and
matching of family or unrelated donor. The search is a complex medical procedure, performed
by dedicated search centers. For successful matching, fluent generation of tests’ results and perfect information flow is crucial and it must be strictly coordinated between the patient,
transplant center, donor registries, donor centers, laboratories and a national hub. Efficient
and persistently managed donor search procedure can be currently successful for as much as
85% of patients. Immunogenetic match is depended on amino acid sequence of human leukocyte
antigens (HLA) molecules (phenotype) being in turn determined by the donor and recipient
genotypes at DNA level. Chief measure of transplant outcome is overall survival of transplanted
patients that is influenced by the level of HLA match and some biological features of the donor,
such as age, sex, number of transfusions and pregnancies, CMV infection status, and a number
of transplanted stem cells, between else. Transplantation in remission of disease is also highly
relevant measure of transplant success and it is strongly dependent on the diagnosis, timing of
the initial transplantation decision, availability of suitable donor, efficiency of donor matching,
and recognition of week and strong points of donor-recipient matching system. In this article
current immunogenetics, biology and organization determinants and requirements of stem cell
donor-recipient matching system have been presented.

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Hematology in Clinical Practice