Cord Blood HLA Matching and Compatibility 3

Question 1

What are donor-specific antibodies (DSAs) and why are they clinically important in cord blood transplantation?

Accepted Answer

Pre-formed recipient antibodies against donor HLA antigens that can cause graft rejection

Answer

Antibodies produced by the donor that protect the recipient

Answer

Antibodies that improve engraftment by targeting donor cells

Answer

Naturally occurring antibodies with no clinical significance

Question 2

Which patient population is most likely to be sensitized and carry pre-formed HLA antibodies?

Accepted Answer

Patients with a history of prior transfusions, transplants, or pregnancies

Answer

Pediatric patients with no prior medical interventions

Answer

Patients who have never received blood products

Answer

Patients with primary immunodeficiency disorders

Question 3

What laboratory test is used to screen transplant recipients for pre-formed HLA antibodies?

Accepted Answer

Panel Reactive Antibody (PRA) testing

Answer

Western blot assay

Answer

Complement fixation test

Answer

Enzyme-linked immunospot (ELISpot) assay

Question 4

What does 'antigen-level' HLA matching mean in cord blood transplantation?

Accepted Answer

Matching based on serologically defined broad HLA groups at low resolution

Answer

Matching at the full DNA sequence level for every exon

Answer

Matching only HLA class I antigens while ignoring class II

Answer

Matching at the amino acid sequence level of the entire HLA protein

Question 5

Why does cord blood expand the transplant donor pool for patients with rare HLA types compared to adult unrelated donors?

Accepted Answer

Cord blood's tolerance for HLA mismatch makes it accessible when a matched adult donor cannot be found

Answer

Cord blood always provides a 6/6 HLA match for any patient

Answer

Adult donors can only donate to patients of the same ethnicity

Answer

Cord blood units are typed at lower resolution, hiding mismatches

Question 6

Which factor, alongside HLA matching, is most critical in selecting a cord blood unit for transplantation?

Accepted Answer

Total nucleated cell (TNC) dose relative to recipient body weight

Answer

The age of the cord blood bank

Answer

The geographic location of the cord blood unit

Answer

The gender of the cord blood donor

Question 7

What is the role of a Cord Blood Coordinating Center in the HLA matching process?

Accepted Answer

To coordinate global registry searches and facilitate selection of compatible cord blood units for patients

Answer

To perform all HLA typing directly on cord blood units

Answer

To manufacture synthetic HLA antigens for laboratory testing

Answer

To provide post-transplant HLA monitoring for all recipients