Hlamatched Unrelated Donors

While HLA-identical sibling donors produce the best transplant outcomes,84 closely matched unrelated donors (MUD) can also produce acceptable results.9697 Sources of stem cells for unrelated donor transplants include bone marrow97 peripheral blood stem cells (PBSC),98 and umbilical cord blood cells.99-103

In sibling donor transplants, serologic or low resolution HLA testing sufficient to prove haplotype identity is adequate, but this is not the case when unrelated donors are being considered. With the advent of DNA-based HLA testing, it was quickly apparent that sero-logically defined HLA antigens represent multiple distinct alleles in most cases.55 The available literature on the role of HLA matching in stem cell transplant outcome varies both with regard to the number of HLA loci tested and the resolution level of the testing performed.

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