Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Sep 24, 2016; 6(3): 532-541
Published online Sep 24, 2016. doi: 10.5500/wjt.v6.i3.532
Genetic barriers in transplantation medicine
Hisham A Edinur, Siti M Manaf, Nor F Che Mat
Hisham A Edinur, Forensic Science Programme, School of Health Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
Siti M Manaf, Nor F Che Mat, Biomedicine Programme, School of Health Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
Author contributions: Edinur HA designed and wrote the review paper; Manaf SM and Che Mat NF wrote the review paper.
Conflict-of-interest statement: The authors declare that there is no conflict of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hisham A Edinur, PhD, Forensic Science Programme, School of Health Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia. edinur@usm.my
Telephone: +60-9-7677641 Fax: +60-9-7677515
Received: March 30, 2016
Peer-review started: March 31, 2016
First decision: May 17, 2016
Revised: May 31, 2016
Accepted: July 11, 2016
Article in press: July 13, 2016
Published online: September 24, 2016
Processing time: 176 Days and 20.6 Hours
Abstract

The successful of transplantation is determined by the shared human leukocyte antigens (HLAs) and ABO blood group antigens between donor and recipient. In recent years, killer cell receptor [i.e., killer cell immunoglobulin-like receptor (KIR)] and major histocompatibility complex (MHC) class I chain-related gene molecule (i.e., MICA) were also reported as important determinants of transplant compatibility. At present, several different genotyping techniques (e.g., sequence specific primer and sequence based typing) can be used to characterize blood group, HLA, MICA and KIR and loci. These molecular techniques have several advantages because they do not depend on the availability of anti-sera, cellular expression and have greater specificity and accuracy compared with the antibody-antigen based typing. Nonetheless, these molecular techniques have limited capability to capture increasing number of markers which have been demonstrated to determine donor and recipient compatibility. It is now possible to genotype multiple markers and to the extent of a complete sequencing of the human genome using next generation sequencer (NGS). This high throughput genotyping platform has been tested for HLA, and it is expected that NGS will be used to simultaneously genotype a large number of clinically relevant transplantation genes in near future. This is not far from reality due to the bioinformatics support given by the immunogenetics community and the rigorous improvement in NGS methodology. In addition, new developments in immune tolerance based therapy, donor recruitment strategies and bioengineering are expected to provide significant advances in the field of transplantation medicine.

Keywords: Transplantation; ABO blood group; Human leukocyte antigen; MICA; Killer cell immunoglobulin-like receptor; Graft rejection; Graft vs host disease

Core tip: Transplantation is a systematic medical procedure for patients with organ failure and haematological disorders. Immunologically compatible donor and recipient are determined by several genetic markers which include matching for ABO blood group, human leukocyte antigen, MICA and killer cell immunoglobulin-like receptors. The elucidation of genes code for these markers of tissue identity reviewed here and significant advancement in the field of transplant immunology are expected to have a positive impact on transplantation medicine. These include both the waitlisted and transplanted patients.