Donor relationship
Indicate the relationship between the donor and recipient.
Related
A related donor is a blood-related relative. This includes monozygotic (identical twins), non-monozygotic (dizygotic, fraternal, non-identical) twins, siblings, parents, aunts, uncles, children, cousins, half-siblings, etc.
Unrelated
An unrelated donor is a donor who shares no known ancestry with the patient, including adoptive parents/ children or stepparents/children.
In order to interpret HLA typing results, start at a locus such as HLA-A*. Find the “*” and look at the numbers going to the right. The first two digits are the antigen family. The 3rd, 4th, and occasional 5th digits are at the allelic level.
Example: 8/8 match at –A, -B, -C, and -DRB1
HLA Typing Results
| Relation | -A | -B | -C | -DRB1 |
|---|---|---|---|---|
| Recipient | *02:06 | *52:01 | *12:02 | *15:02 |
| Recipient | *03:01 | *57:02 | *04:01 | *07:01 |
| Donor | *02:06 | *52:01 | *12:02 | *15:02 |
| Donor | *03:01 | *57:02 | *04:01 | *07:01 |
HLA-A locus: Matched
HLA-B locus: Matched
HLA-C locus: Matched
HLA-DRB1 locus: Matched
HLA match results: Check the donor-recipient matching for each of the following HLA loci
HLA-A
Indicate the number of matches at the HLA-A locus
- 0/2
- 1/2
- 2/2
HLA-B
Indicate the number of matches at the HLA-B locus
- 0/2
- 1/2
- 2/2
DRB1
Indicate the number of matches at the HLA-DRB1 locus
- 0/2
- 1/2
- 2/2
HLA-C
Indicate the number of matches at the HLA-C locus
- 0/2
- 1/2
- 2/2
- Not tested
DR3/4/5
Indicate the number of matches at the HLA-DR3/4/5 locus
- 0/2
- 1/2
- 2/2
- Not tested
DRQA1
Indicate the number of matches at the HLA-DRQA1 locus
- 0/2
- 1/2
- 2/2
- Not tested
DQB1
Indicate the number of matches at the HLA-DQB1 locus
- 0/2
- 1/2
- 2/2
- Not tested
DPA1
Indicate the number of matches at the HLA-DPA1 locus
- 0/2
- 1/2
- 2/2
- Not tested
DPB1
Indicate the number of matches at the HLA-DPB1 locus
- 0/2
- 1/2
- 2/2
- Not tested
Upload a de-indentified copy of the HLA typing results with both the recipient and donor allelic subtypes identified __________
Upload a de-identified copy of the HLA typing results that includes the participants Kidney Tolerance study ID number. If multiple HLA typing results were reported, upload the assessment closest to the transplant date. Acceptable file types include: PDF, DOC, and DOCX.
Retain a copy of the HLA typing results in the case history file
CCG v.1 | CRF v.1
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