Human Immunology· 2026Q2
Challenges in HLA and ABO typing of deceased organ donors with prior hematopoietic stem cell transplantation: two cases and practical considerations for evaluation
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- Q2SCImago
- 2026year
Short summary
Prior hematopoietic stem cell transplantation (HSCT) in deceased organ donors can lead to conflicting HLA and ABO blood group typing results due to chimerism, complicating organ allocation.
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Key points
- Prior HSCT can cause mixed chimerism in deceased organ donors, affecting HLA and ABO typing.
- Case 1 showed HLA-C and HLA-DQ discordance between donor and recipient, with peripheral blood reflecting the HSCT donor and a kidney specimen showing mixed sources.
- Case 2 had concordant HLA but ambiguous ABO serology, leading to allocation as AB, later explained by mixed donor/recipient DNA.
- Accurate typing requires integrating transplant history, historical records, specimen source, serology, and molecular testing.
AI-generated from the title and abstract; the full text is not read.
Abstract
BACKGROUND: Prior allogeneic hematopoietic stem cell transplantation (HSCT) can complicate HLA and ABO typing of deceased organ donors because circulating hematopoietic cells and organs may originate from different sources. CASE PRESENTATIONS: We describe two deceased organ donors with prior HSCT. In Case 1, historical records demonstrated discordance at HLA-C and HLA-DQ between the HSCT donor and the constitutional pre-HSCT typing. Peripheral-blood HLA typing reflected the HSCT donor, while a kidney blood-vessel specimen yielded four DPB1 alleles from mixed sources, permitting only a presumptive kidney DPB1 assignment. In Case 2, HLA assignments were concordant after childhood HSCT, but ABO serology was O/A ambiguous, resulting in allocation as blood group AB. Retrospective molecular ABO genotyping and chimerism testing demonstrated mixed donor- and recipient-derived DNA in buccal specimens. CONCLUSIONS: HSCT-associated chimerism can complicate deceased-donor HLA and ABO typing. Interpretation should integrate transplant history, historical records, specimen source, serology, and molecular testing when indicated.
The authors' abstract, as published at the source. Human Immunology, 2026 · DOI ↗
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Field: Transplantation
TransplantationMedicine