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HLA equivalency table updates and addition of DPB1 epitopes now in effect

Jun 17, 2021 | Histocompatibility, Policy changes, UNet℠ system changes

HLA equivalency table updates and addition of DPB1 epitopes now in effect

Audience:

  • All histocompatibility Primary Lab Directors and Primary Data Coordinators
  • All transplant Primary Program Administrators and Primary Data Coordinators
  • All Primary OPO Administrative Directors and Primary OPO Medical Directors
  • Members of the OPTN Histocompatibility Committee
  • All OPTN Representatives and Alternate Representatives

Implementation date

June 17, 2021

At-a-glance

Changes are now in effect for HLA and unacceptable antigen options, as well as to the equivalences used for HLA matching and screening of unacceptable antigens between candidates and donors.

These changes include:

  • New B and DR matching equivalences
  • New B unacceptable alleles and equivalences
  • New unacceptable equivalences for Bw4 and Bw6
  • New C unacceptable alleles and equivalences
  • New DR unacceptable allele and equivalences
  • A new epitope-based assignment for DPB1 unacceptable alleles
  • New DPB1 reportable antigens for donors
  • Removal of some B matching equivalences and unacceptable alleles
  • Removal of some DR unacceptable equivalences
  • Removal of some DPB1 reportable unacceptable antigens
  • Removal of DQB1 “1” and corresponding unacceptable antigen equivalences

Change details

The following HLA and unacceptable antigens are now present in WaitlistSM, KPDSM, DonorNet® and TIEDI®:

  • B 07:03*
  • B 27:03*
  • B 83:01
  • C 03:05
  • C 04:04
  • C 04:07
  • C 05:01
  • C 06:02
  • C 07:06
  • C 07:18
  • C12:04
  • C 15:04
  • C 15:06
  • C 15:09
  • C 16:04
  • DR 103

*indicates an item that has previously existed as a HLA option and is a new unacceptable antigen option

In addition, DQB1 “1” has been removed in the HLA and unacceptable antigen section throughout UNetSM, including the KPD other antibody specificity section.

This list is not inclusive of all the changes. Refer to the policy notice to see the equivalency changes that will affect donor to candidate screening and matching.

Other changes you will see throughout UNet

In the Waitlist and KPD unacceptable antigen sections, there is now a separate option to select DPB1 epitopes.  Selecting an unacceptable epitope results in a number of donor equivalences that will be used to screen against candidates.

  • Refer to the the policy notice for the full list and all epitope-based matching equivalences.

Additionally, Calculated Panel Reactive Antibody (CPRA) scores for kidney, pancreas and kidney-pancreas, and KPD candidates may change.

  • As of the June 17 implementation, Waitlist and OPTN CPRA calculators have been updated to include the unacceptable updates and the removal of DQB1 “1”.
  • If you use your own CPRA calculator, you will need to update it to be in sync with UNet calculation.

How to import DPB1 Epitopes in Waitlist Import Unacceptable Antigen Utility

With the addition of the new DPB1 epitopes, the following format should be used to import into Waitlist:

  • DPB55EAE, DPB55DED, DPB55DEE, DPB84DEAV, DPB84GGPM, DPB84VGPM

Additional information

The Histocompatibility Committee must annually review and recommend any changes needed to the tables. The changes to the equivalency tables are intended to reflect changes in HLA typing practice and improve organ allocation.

Policy resources

The following policy notice contributed to these system changes: HLA Equivalency Table Updates 2020 (Including Expedited Pathway for Future Updates

Questions

If you have questions relating to implementation, contact UNOS Customer Service at [email protected], or call 800-978-4334 from 8 a.m. to 7 p.m. ET.

For policy-related questions, contact [email protected].

The Organ Center is available 24 hours a day at 800-292-9537.

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