Response: Good Ethics Require Good Science: Why Transplant Programs Should Not Disclose Misattributed Parentage


To the Editor:

Regarding the personal viewpoint article by L. F. Ross (Am J Transplant 2010; 10: 742), the admonishment for careful evaluation and meaningful interpretation of biologically incongruous results is valid and cannot be overstated. However, the indictment of using genetic test systems to evaluate parentage is not. The article cites extremely rare genetic events to support this contention. By the same reasoning, HLA and ABO typing should not be used in transplantation. The HLA system is the single most polymorphic system known and the single most powerful tool for discriminating biologic identity and relationships. Using just the HLA-A and HLA-B loci alone will exclude 97% of men falsely accused of paternity (1). Hence, HLA phenotyping had a legally accepted use in parentage testing for years. Further, many HLA laboratory directors have extensive experience and expertise in parentage testing. If parentage is in doubt, the protocol for verifying and handling that information should be determined by each transplant program and should consider the consequences of disclosure and nondisclosure. However, the issue of the genetic relationship between individuals can be assessed, safely and accurately, using HLA and ABO typing.