HSC transplantation, printed

Donor criteria

Matching of transplantation barriers

The best results are obtained when donor and recipient are HLA-matched (identical or compatible for the HLA antigens) and the identification of the most compatible donor by HLA typing is the highest priority. Read more...

Incompatibility of blood group antigens between donor and recipient is not a barrier in HSC transplantation as stem cells do not express blood group antigens. However, because massive lysis of ABO-mismatched erythrocytes may cause complications, they should be depleted from the graft.

Minor histocompatibility antigens cannot taken into account because the number of minor histocompatible antigens is too high to expect that some donors will be better matched than others and to date, there is little evidence that being mismatched for a particular minor antigen is less favorable than being mismatched for another. Furthermore, perhaps as a consequence of the first argument, no routine tests exist for the typing of minor histocompatibility antigens.

Other criteria

Owed to the importance of being HLA-compatible, other criteria will only be considered if more than one HLA-identical donor is available. Then other parameters such as the CMV-status, age or blood group compatibility may become selection criteria. In addition, one may prefer a donor of the same gender reasoning that in these combinations are more compatible for minor histocompatibility antigens because the sex-linked minor histocompatibility antigens are matched.