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To study the genetic variability of the HLA loci A, B, DR, and DQ in the Netherlands, we analyzed more than 13,000 typings provided by the Dutch National Reference Laboratory for Histocompatibility. To investigate any possibly existing population structure, we subdivided the typings by the geographic location of residency of donors and by the historical belonging of their surnames to given provinces. Concerning possible geographic patterns, we found no significant differences between the four provinces examined (North Holland, South Holland, Utrecht, Zeeland). To assess whether such a negative result was related to recent immigration to the area (the richest of the country) that erased possible preexisting patterns of HLA diversity, we reprocessed the database according to the surnames of HLA donors. We obtained two groups: (1) those having a surname typical of the four provinces they inhabit and (2) those with surnames coming from elsewhere. Such an analysis was made possible because of the availability of a database concerning the geographic origin of most Dutch surnames. Even with this surname-based approach, no major differences were found. We conclude that either the western part of the Netherlands was genetically homogeneous before the official introduction of Dutch surnames two centuries ago by Napoleon or surnames have no power in dissecting HLA variability; that is, such variability is the result of recombination phenomena that surnames cannot mirror because they are transmitted virtually unchanged generation after generation. A comparable study by other investigators recommended the use of family names to identify rare HLA haplotypes in France, but now, concerning the Netherlands, we find opposite results. We suggest that a few typing centers may be sufficient to type bone marrow donors, because HLA genetic differences between the different provinces of the Netherlands are extremely low. To maximize the number of donors, such centers should be located in areas providing the easiest access to the largest population of possible donors, thus disregarding the search for a local variability that we did not find.

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