Resumen

BENGOCHEA, Milka et al. HLA-A, -B, -DR en receptores de trasplante de médula ósea en Uruguay.: Sistema nacional de registro, tipificación y búsqueda de donantes de médula ósea y progenitores hematopoyéticos (SINDOME). Rev. Méd. Urug. [online]. 2003, vol.19, n.2, pp.149-158. ISSN 1688-0390.

Summary Background and Objective: as starting point Uruguay has as starting pointa transplant solidarity system based upon the Fondo Nacional de Recursos and the Banco Nacional de Organos y Tejidos (BNOT). HLA compatibility is a biological boundary in allogenic bone marrow transplantation (BMT). HLA allele and haplotype frequencies are used to determine the probability to find a donor with a particular HLA phenotype and to predict the degree of HLA mismatching in a bone marrow donation scheme. In Uruguay, all potential donors are typified in In the Immunogenetic and Histocompatibility Laboratory of the BNOT are typified all potentials bone marrow recipients and donors from all the country. In this context a program was developed for the register, to register, evaluate, and procure the non-related evaluation and procurement of non-related potential bone marrow donors at national level known as SINDOME. Our aim was to analyzed bone marrow donors and recipients for allogenic transplantations registered in our register from January 1997 to May 2002. We also determined the genetic constitution of HLA system for 298 bone marrow recipients. Method: 346 recipients and 1083 donors were analyzed. Allele and haplotype frequencies were determined in a sample of 298 recipients. HLA class I alleles were typing by standard complement-dependent microcytotoxic assays. HLA class II alleles werewas determined by polymerase chain reaction­sequence specific oligonucleotide (PCR-SSO) technique, with medium-high resolution. We analyzed allele and haplotype frequencies in a sample of 298 recipients. Results: among the 346 bone marrow recipient subjects recorded in the SINDOME, 58% were younger than 30 years. Donor/recipient rate was 3.13 but only 45% of potential receptors matched with a compatible donor. HLA-A, -B, -DR polymorphism analysis of the sample showed that prevalent alleles were A2 (28.97%), B35 (12.49%) and DR04 (15.24%). Only the HLA-DRB1 loci locus showed a highly significant deviation from Hardy-Weinberg equilibrium. Most common haplotypes were A2-B51 and A2-B7 for HLA-A, -B, A2-DR11 and A2-DR04 for HLA-A -DRB1, and haplotype B8-DR03 for HLA-B-DR. Highest frequencies were observed in HLA-A1-B8-DR03 and HLA-A2-B51-DR13 for haplotypes HLA-A-B-DRB1. Conclusion: oour findings showed that HLA system is heterogeneous, with a wide range of polymorphisms and haplotype distribution. The possibility to find compatible donors for a group of patients with malignant diseases without sibling donors is low in our country. In these cases, searching in international donor records might be an alternative to find potential suitable marrow donors for allogenic transplantations.

Palabras clave : ANTÍGENOS HLA-A [genética]; ANTÍGENOS HLA-B [genética]; ANTÍGENOS HLA-DR [genética]; HISTOCOMPATIBILIDAD; TRANSPLANTACIÓN DE MÉDULA ÓSEA; TRANSPLANTACIÓN DE CÉLULAS MADRES HEMATOPOYÉTICAS; URUGUAY.

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