HLA stands for human leukocyte antigens. HLA markers are proteins found on most cells in your body. Your immune system uses these proteins — or markers — to recognize which cells belong in your body and which do not. If an allogeneic transplant (which uses cells from a family member, unrelated donor or cord blood unit) is a treatment option, your doctor will take a blood sample to test for your HLA type. Your doctor will search for a donor or cord blood unit with an HLA type that closely matches yours.
Ask your doctor for a copy of your HLA typing lab report. You may also want to ask your doctor to show you how to read the report.
If you have not been tested for your HLA type, talk with your doctor. Ask your doctor if an allogeneic transplant is a treatment option for you. If a transplant is an option, it is a good idea to see a transplant doctor (have a consultation) early after your diagnosis. Your first treatment may not be a transplant, but a transplant doctor can help you and your primary doctor look at all your treatment options and plan ahead.
A match is a donor or cord blood unit with specific HLA markers that are the same as yours. Research has found that a small number of HLA markers are most important to transplant outcomes. These are the markers transplant doctors look at when they match donors with patients. The best available donor or cord blood unit may match you at all or at most of the HLA markers your doctor looks at. Many patients who receive an unrelated donor transplant have a partially matched donor or cord blood unit.
A well-matched donor or cord blood unit is important for your transplant, but it is only one of the things that can affect your outcome. For cord blood transplants, the number of blood-forming cells in the cord blood unit is important. Your disease, the stage of your disease, your age and general health can all affect how well you will do. Doctors will consider all these things when making decisions about a transplant.
The matches listed in your results are called potential matches because more information is needed to find out if the donors or cord blood units are suitable and available. Most donors are typed at a basic level for 6 HLA markers when they join the NMDP Registry. The NMDP can recruit more donors by keeping HLA typing costs low. One way we do this is by testing for the minimum HLA information that transplant centers need to start a donor search. However, transplant centers will need more details to find the best available donor or cord blood unit.
If you need an unrelated donor or cord blood transplant, your primary doctor will refer you to an NMDP transplant center for a consultation. An NMDP transplant center will look at the best potential donors and/or cord blood units and ask for more testing at a high level of detail. This is called a formal search.
Further testing may show that some donors do not match at a detailed level, or at all the markers your center requires. In addition, some donors or cord blood units may not be available. For example, a donor’s health may have changed, making him or her unable to donate. Transplant centers also look at other factors, such as the age of adult donors. For cord blood transplants, the number of blood-forming cells in a cord blood unit is important. The number of blood-forming cells needs to be suitable for the size of the patient — larger patients need more cells. The transplant center wants to make sure you receive the best possible donor or cord blood unit for you.
Do my results include all potential donors in the world?
No. MatchView shows you potential matches on the NMDP Registry at the moment you use the tool. The NMDP Registry includes nearly 7 million adult donors and nearly 70,000 cord blood units. It is updated constantly as new donors and cord blood units are added and others are removed.
There are also other donor registries and cord blood banks. When your doctor conducts a search through the NMDP, he or she can search an additional 4 million donors and more than 290,000 cord blood units worldwide.
What is a 6 of 6 match? Why does MatchView include only 6 markers if a transplant center looks at more?
A 6 of 6 match is a donor or cord blood unit that matches you at 6 HLA markers: two A, two B and two DRB1.
Before a donor can be considered for use in a transplant, the NMDP requires a match of at least 5 of these 6 markers. For cord blood units — which require less stringent matching criteria — the NMDP requires a match of at least 4 of these 6 markers. These minimum requirements are based on research studies of transplant outcomes.
MatchView looks at these 6 markers based on NMDP minimum matching requirements and because this is the HLA information available for most donors. Most donors are typed at a basic level for these 6 HLA markers when they join the Registry. The NMDP can recruit more donors by keeping HLA typing costs low. One way we do this is by testing for the minimum HLA information that transplant centers need to start a donor search.
To select the best available donor or cord blood unit, an NMDP transplant center will look at more detailed information. For most centers, this includes looking at more than 6 HLA markers (many also look at C and DQB1). A transplant center will ask for additional testing to find a donor or cord blood unit that matches you at a detailed level.
If your results here show few matches, this does not rule out a transplant for you. Talk with your doctor about your results. If an unrelated donor transplant is a treatment option, your primary doctor will refer you to an NMDP transplant center. The transplant center will work with the NMDP to conduct a worldwide search for the best available donor or cord blood unit. Your center may find a suitable donor on another registry or among the new donors and cord blood units added to the NMDP Registry every day.
It is also important to remember that the level of matching is only one of the things that affects your chances of having a successful transplant. Many patients who receive unrelated donor transplants have a partially matched donor or cord blood unit. Your disease, the stage of your disease, your age and your general health all can affect how you respond to a transplant. Your doctor will consider all these things when making decisions about a transplant.
How do I find a donor or cord blood unit for my transplant?
You are not responsible for finding your own donor. If you need an unrelated donor or cord blood transplant, your primary doctor will refer you to an NMDP transplant center. Your transplant center will work with the NMDP to find a donor or cord blood unit for you.
In general, we encourage patients and their immediate families to focus their energies on caring for the patient. The NMDP’s ongoing recruitment efforts add nearly 33,000 new donors to the Registry each month. However, some families want to get involved in recruiting donors to the NMDP Registry. If you want to raise awareness about the need for donors, we can help you. To learn more, see Recruit Donors.
How does a transplant center choose the best donor or cord blood unit for me?
After your primary doctor refers you to an NMDP transplant center, your transplant center will work with the NMDP to find a donor or cord blood unit for you. Your transplant center will request more tests to see if a potential donor or cord blood unit is a suitable match. Sometimes more testing shows that potential donors or cord blood units do not match you at all the details or markers your center requires.
Your transplant center will also look at other information. For cord blood transplants, the number of blood-forming cells in the cord blood unit is important. The number of blood-forming cells in a transplant needs to be suitable for the weight of the patient — larger patients need more blood-forming cells. When choosing an adult donor, your center may look at the donor’s age, sex, size and other factors. How quickly you need a transplant and your disease status, your age and your general health can also affect your transplant center’s strategy in choosing a donor or cord blood unit.
Why do my results show a different number of potential matches than my transplant center says I have?
If you have already been referred to an NMDP transplant center, your transplant team will have details about your potential matches. Your transplant center can give you the most accurate number of potential donors and cord blood units for you. Some reasons your transplant center may report a different number of potential donors and cord blood units than appear in your MatchView results include:
MatchView shows only donors and cord blood units on the NMDP Registry. When your transplant center conducts a search through the NMDP, it has access to additional donors and cord blood units from registries worldwide.
Some of the potential donors and cord blood units in your MatchView results may not meet the requirements of your transplant center.
Some potential donors or cord blood units in your MatchView results may not be available. For example, a potential donor’s health may have changed, making him or her unable to donate.
How long will it take to find a donor or cord blood unit for my transplant?
Your transplant team will work with the NMDP to conduct a worldwide search to find you the best available donor or cord blood unit. This can take as little as 2 weeks to as long as 2 months or more. Cord blood units are stored and ready to use, so if you need a transplant quickly, your doctor may consider using cord blood. Sometimes no suitable match can be found. If that happens, your doctor will look at other treatment options.
Starting the donor search early may improve your chances of getting a transplant when you need one. If a transplant is an option for you, it is a good idea for your primary doctor to refer you to a transplant doctor for a consultation early after your diagnosis. A transplant doctor can work with your primary doctor to find the best time for a possible transplant and to plan early treatments that will not rule out a transplant later.
Print your results and bring them to your doctor. You can use them as a resource to talk about whether a transplant is a treatment option. If an unrelated donor or cord blood transplant is an option, your primary doctor will refer you to an NMDP transplant center. There are more than 170 NMDP transplant centers in the United States as well as international transplant centers and registries where you may be able to receive an unrelated donor transplant. For transplant center information, see Choosing a Transplant Center. For information about MatchView to share with your doctor, see the MatchView Physician Information.
We are here to help. If you have questions about your MatchView results, the search and transplant process or finding a transplant center, contact the NMDP Office of Patient Advocacy.
Call toll free in the United States: 1 (888) 999-6743
Staff is available Monday through Friday, 8 a.m. to 5 p.m. Central time.
For questions about how a transplant fits into your treatment plan, talk to your doctor.
If you already have a search in progress, your transplant center has the most complete information about the status of your search. If you don’t know who to talk to at your transplant center, or you need help in a language other than English, you can contact the NMDP.
How do I use this information to talk with my doctor?
You can use your MatchView results as a resource to talk to your doctor about whether a transplant is an option for you. Talking openly can help you and your doctor make better choices about your health care. Your doctor will explain the treatment options he or she feels are best for you. You can ask your doctor questions to understand your doctor's recommendations. For ideas of what to ask your doctor, see Questions to Ask Your Doctor about Transplant (PDF). For information to help your doctor interpret your MatchView results, see the MatchView Physician Information.
You may also want to share more in-depth information about transplants with your doctor. You can find information to share with your doctor in the Physician Resources section of this Web site:
Hospitals that do marrow or cord blood transplants are called transplant centers. Many transplant centers that do unrelated donor transplants work with the NMDP. You can find a lot of information about NMDP transplant centers in Choosing a Transplant Center: A Patient's Guide.
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