Guidelines for unrelated donor selection
| . | Multiple HLA-A, HLA-B, HLA-C, and HLA-DRB1 (8/8) HLA matched unrelated donors available . | 8/8 match unavailable; multiple 7/8 unrelated donors available . |
|---|---|---|
| 1. Resolution of typing HLA-A, HLA-B, HLA-C, and HLA-DRB1 | High-resolution, matches for ARDs | High-resolution matches for ARDs for 7 matched alleles; |
| Select HLA-C*03:03 vs C*03:04 mismatch, if present; | ||
| No other preference for mismatched loci (HLA-A/B/C/DRB1) or other allele combinations | ||
| 2. Donor age | Select donors of younger age | Select donors of younger age |
| 3. Permissive mismatching HLA-DPB1 | Select matched/permissive DPB1 mismatch based on the algorithm developed by Crivello et al68,70 (http://www.ebi.ac.uk/cgi-bin/ipd/imgt/hla/dpb_v2.cgi) | Select matched/permissive DPB1 mismatch based on the algorithm developed by Crivello et al68,70 (http://www.ebi.ac.uk/cgi-bin/ipd/imgt/hla/dpb_v2.cgi) |
| 4. Matching HLA-DRB3/4/5 and HLA-DQB1 | Minimize mismatches | Minimize mismatches |
| 5. Vector of mismatch | N/A | Select donor with single allele mismatched at patient’s homozygous locus (HLA-A/B/C/DRB1), if applicable |
| 6. DSA in patient | Avoid mismatches of allotypes targeted by DSAs, including DQA1 and DPA1 | Avoid mismatches of allotypes targeted by DSAs, including DQA1 and DPA1 |
| 7. Transplant center practice may differ in additional considerations to use in the selection among multiple donors equivalent for the characteristics above | ||
| . | Multiple HLA-A, HLA-B, HLA-C, and HLA-DRB1 (8/8) HLA matched unrelated donors available . | 8/8 match unavailable; multiple 7/8 unrelated donors available . |
|---|---|---|
| 1. Resolution of typing HLA-A, HLA-B, HLA-C, and HLA-DRB1 | High-resolution, matches for ARDs | High-resolution matches for ARDs for 7 matched alleles; |
| Select HLA-C*03:03 vs C*03:04 mismatch, if present; | ||
| No other preference for mismatched loci (HLA-A/B/C/DRB1) or other allele combinations | ||
| 2. Donor age | Select donors of younger age | Select donors of younger age |
| 3. Permissive mismatching HLA-DPB1 | Select matched/permissive DPB1 mismatch based on the algorithm developed by Crivello et al68,70 (http://www.ebi.ac.uk/cgi-bin/ipd/imgt/hla/dpb_v2.cgi) | Select matched/permissive DPB1 mismatch based on the algorithm developed by Crivello et al68,70 (http://www.ebi.ac.uk/cgi-bin/ipd/imgt/hla/dpb_v2.cgi) |
| 4. Matching HLA-DRB3/4/5 and HLA-DQB1 | Minimize mismatches | Minimize mismatches |
| 5. Vector of mismatch | N/A | Select donor with single allele mismatched at patient’s homozygous locus (HLA-A/B/C/DRB1), if applicable |
| 6. DSA in patient | Avoid mismatches of allotypes targeted by DSAs, including DQA1 and DPA1 | Avoid mismatches of allotypes targeted by DSAs, including DQA1 and DPA1 |
| 7. Transplant center practice may differ in additional considerations to use in the selection among multiple donors equivalent for the characteristics above | ||
DSA, donor-specific HLA antibodies.