IMPACT OF RACIAL GENETIC-POLYMORPHISM ON THE PROBABILITY OF FINDING AN HLA-MATCHED DONOR
IMPACT OF RACIAL GENETIC-POLYMORPHISM ON THE PROBABILITY OF FINDING AN HLA-MATCHED DONOR
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DOI：
10.1097/00007890-199510270-00003
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发表时间：
1995-10-27
期刊：
影响因子：
6.2
通讯作者：
MILFORD, E
中科院分区：
文献类型：
--
作者：
BEATTY, PG;MORI, M;MILFORD, E
由于成功的器官或骨髓移植与患者和捐赠者之间的人类白细胞抗原相容程度相关，已经开发了登记以便于匹配，然而，少数族裔群体找到匹配的机会较低。我们评估了种族遗传多态生物学对不同种族患者找到匹配的可能性的影响。国家骨髓捐赠者计划汇编了20,449名患者和1,625,159名潜在志愿者捐赠者的人类白细胞抗原类型。这些HLA型仅用于估计为不同种族的患者找到匹配的供者的可能性。我们估计了不同种族的HLA单倍型频率，然后确定了找到匹配捐赠者的概率，给定了几个假设的注册大小，我们证实了搜索当前国家骨髓捐赠者计划注册的少数族裔患者找到匹配的概率很低，这只是部分原因来自这些少数族裔的捐赠者数量较少，因为即使假设所有种族的捐赠者注册大小相同，这种观察仍然存在。我们证明，非裔美国人在人类白细胞抗原方面更加多态，因此在任何给定的登记规模下都不太可能找到捐赠者。器官和骨髓捐赠者招募少数族裔的人数增加，只会部分缓解少数族裔患者平等获得人类白细胞抗原配型的问题。因此，尝试改进使用人类白细胞抗原不相合供者进行移植的方法将是很重要的。
As successful organ or marrow transplantation correlates with the degree of HLA-compatibility between patient and donor, registries have been developed to facilitate matching, However, racial minority groups have a lower chance of finding a match. We evaluate the impact of the biology of racial genetic polymorphism upon the probability of finding an HLA match for patients of different racial groups. The National Marrow Donor Program has compiled the HLA types of 20,449 patients and 1,625,159 potential volunteer donors. These HLA types mere used to estimate the probability of finding an HLA-matched donor for patients of different racial groups. We estimated the HLA haplotype frequencies for different races, and then determined the probability of finding matched donors, given several hypothetical registry sizes, We confirmed that patients of minority races searching the current National Marrow Donor Program registry have low probabilities of finding matches, This was only partly due to the smaller number of donors from these racial minorities, as the observation persisted even when hypothetical donor registry sizes were the same for all racial groups. We demonstrate that African-Americans are more polymorphic with respect to HLA, and are hence less likely to find donors at any given registry size. An increase in the recruitment of minority racial groups for organ and marrow donors will only partially alleviate the problem of equal access to HLA matches for patients belonging to racial minority groups. It will therefore be important to attempt to improve methods for transplantation using HLA-mismatched donors.