Direct HLA Genetic Comparisons Identify Highly Matched Unrelated Donor/Recipient Pairs with Improved Transplant Outcome.

•Next-generation sequencing (NGS) of HLA loci can identify polymorphisms in both antigen recognition domain (ARD) and non-ARD encoding exons, introns, and untranslated regions.•NGS-based sequencing of eleven HLA loci in a retrospective cohort of 166 unrelated donor-recipient hematopoietic cell transplantation pairs demonstrated that those with no genetic mismatch had superior survival and acute graft-versus-host disease outcomes, thereby supporting the adoption of NGS for unrelated donor selection.