What are the matching requirements for bone marrow transplantation?

Although bone marrow transplantation plays a positive and effective role in treating diseases in most cases and can alleviate or cure the disease, it is not known that both parties involved in the bone marrow transplant need to meet certain requirements to avoid inevitable consequences during the transplantation process. Then you need to understand the bone marrow transplant matching, that is, the bone marrow transplant matching requirements are as follows:

Select a donor that is histocompatible with the recipient. When selecting a suitable donor, the first step is to choose a marrow donor from among siblings. If this fails, a marrow donor will be sought among close relatives and unrelated volunteers.

In donor selection, HLA testing is first performed on siblings using serological methods. When the results are similar, lymphocyte culture (MLC) is performed to detect the D locus and verify HLA matching. In terms of HLA matching, the main matching is done on three pairs of loci: HLA-A, HLA-B and HLA-DR. Hematopoietic stem cell transplantation can only be performed when the HLA matching of two individuals is exactly the same.

Since HLA-AB has the most obvious diversity, HLA-AB typing is usually done first. After the HLA-AB of the donor and recipient are matched, the donor is then tested for HLA-DR typing. If the HLA of the donor and recipient are completely matched and the donor passes the health check, preparations for the transplant surgery can begin. The patient receives a transplant after chemotherapy and radiation therapy destroy the patient's diseased blood-forming cells.

Syngeneic bone marrow transplantation does not involve immune incompatibility issues, as does autologous bone marrow transplantation, because the donor and recipient are genetically identical. The donor bone marrow cells of allogeneic bone marrow transplantation are genetically different from the recipient cells. Compared with organ transplants such as kidney, liver, and heart, rejection reactions are more likely to occur. Once the donor bone marrow is engrafted, graft-versus-host disease may occur. Therefore, strict tissue matching must be performed between the donor and the recipient.