Chapter Category: MHC

From the book Minor Histocompatibility Antigens: From the Laboratory to the Clinic

Mapping Human Minor Histocompatibility Genes

Patrick G. Beatty and James C. Jenkin

In allogeneic human blood and bone marrow transplantation, it has been apparent for many years that although disparity for HLA can contribute to both graft rejection and graft versus host disease, there are also important non-HLA loci involved. This conclusion is based on observations that graft versus host disease (GVHD) is extremely rare when transplants are carried out between genotypical identical twins, but is present even when there is genetic identity for HLA by inheritance, such as would happen when transplants take place between HLA matched siblings. Indeed, if no immunosuppression is given in marrow transplant between HLA matched siblings, the incidence of fatal graft versus host disease is extremely high. Thus, although matching for HLA is an important, though not an absolute, requirement for a successful transplant, clearly there are other antigen systems involved: by definition the minor histocompatibility (H) antigens. These minor H antigens are particularly important when transplants are carried out between HLA matched unrelated individuals. The probability of mismatch for minor H antigens is higher for an unrelated patient/donor pair than if the transplant is between HLA matched siblings, as siblings would have some shared inheritance of genes encoding minor H antigens, and unrelated patient/donor pairs would not.

Taken from the book

Minor Histocompatibility Antigens: From the Laboratory to the Clinic

Edited by: Patrick G. Beatty and James C. Jenkin

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