Review of HLA Tables 2016 Histocompatibility Committee 1

Review of HLA Tables (2016) Histocompatibility Committee 1

What problem will the proposal solve? § Members need updated antigens in UNet. SM § As a result of the naming process for DPB 1 alleles, there is no relationship between the allele designation and the protein structure. § Only a small number of DPB 1 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 § Nomenclature in tables is out of date 2

What are the proposed solutions? § Update existing equivalency tables § Add HLA-DPB 1 unacceptable antigen table, including G alleles § Update nomenclature in all equivalency tables to reflect proper WHO designations. § HLA-A 101 HLA- A*01: 01 3

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 4

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 5

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