Pretransplant human leukocyte antigen (HLA) antibodies have an established role in failed engraftment after single-unit cord blood transplantation. Their role in double-unit cord blood transplantation (DCBT) engraftment, however, is more controversial. Some transplant centers advocate pretransplant screening of the recipient for HLA antibodies, and avoidance of units with the corresponding antigens if antibodies are detected.
Fellow Parastoo Dahi describes a study showing that graft-specific HLA antibodies do not influence unit dominance or prevent high rates of sustained donor engraftment in DCBT. The findings suggest that the presence of graft-specific antibodies should not preclude DCBT.