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Review of HLA Tables (2016)

This review discusses the current problems with HLA tables and proposes solutions to ensure accurate organ matching, including updating tables and nomenclature. The implementation process for members and the OPTN is detailed.

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Review of HLA Tables (2016)

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  1. Review of HLA Tables (2016) Histocompatibility Committee

  2. What problem will the proposal solve? • Members need updated antigens in UNetSM • As a result of the naming process for DPB1 alleles, there is no relationship between the allele designation and the protein structure. • Only a small number of DPB1 antigens are present on commercial antibody testing kits. • Hence, the possibility exists that an incompatible organ may be inappropriately offered to a candidate. The downstream impact ranges from an unexpected positive crossmatch to early AMR and graft loss. • Nomenclature in tables is out of date

  3. What are the proposed solutions? • Update existing equivalency tables • Add HLA-DPB1 unacceptable antigen table, including G alleles • Update nomenclature in all equivalency tables to reflect proper WHO designations. • HLA-A 101  HLA- A*01:01

  4. How will members implement this proposal? • Members should: • familiarize themselves with updates to tables • review and modify unacceptable antigens for candidates based on changes to tables • Members must update their references and reporting methods to reflect changes in nomenclature

  5. How will the OPTN implement this proposal? • Anticipated Board of Directors Review: Dec. 2017 • Programming – IT will update tables in Policy 4.10 with changes to nomenclature and antigens • Committee will evaluate 1 year post-implementation

  6. Questions? Robert A. Bray, Ph.D., D(ABHI), HCLD/CC(ABB) Committee Chair rbray@emory.edu Alison Wilhelm Committee Liaison alison.wilhelm@unos.org

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