Coming June 17: HLA equivalency table update and addition of DPB1 epitopes

Coming June 17: HLA equivalency table update and addition of DPB1 epitopes

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
  • Please share this notice with anyone in your organization who would benefit from it

Implementation date

June 17, 2021

At-a-glance

At its June 2020 meeting, the OPTN Board of Directors approved the recommendation from the Histocompatibility Committee to update Policy 4.10: Reference Tables of HLA Antigen Values and Split Equivalences. This will result in changes to HLA and unacceptable antigen options as well as the equivalencies used for HLA matching and screening of unacceptable antigens between candidates and donors.

  • These changes include certain B and DR matching equivalences, certain B, C, DR, DPB1 unacceptable alleles, a new epitope-based assignment for DPB1 unacceptable alleles, update of DPB1 reportable antigens, and removing one DQB1 antigen.
  • These changes will occur in DonorNet®, Waitlist℠, TIEDI® and KPD℠ applications. The “All Other Antibody Specificity” fields in KPD will also be affected.
It is critical that you are aware of what is being added or removed so that you know what you need to do for particular patients, which in some cases may involve retesting or changing the way you report data.
If you have a candidate affected by the removal of DQB1 “1”, you will receive a separate notification.
Change details
On June 17, the following HLA and unacceptable antigens will be present in Waitlist, KPD, 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

In addition, DQB1 1 will be removed in the HLA and unacceptable antigen section throughout UNet℠, including the KPD other antibody specificity section.

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 will be 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.

The reportable list of DPB1 unacceptable antigens differs from the reportable DPB1 HLA, so refer to 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.

  • On June 17, we will update the Waitlist and OPTN CPRA calculators to include the unacceptable antigen changes.
  • 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 proposed changes to the equivalency tables are intended to reflect changes in HLA typing practice and improve organ allocation.

Policy resources

Questions

If you have questions relating to implementation, contact UNOS Customer Service at unethelpdesk@unos.org, or call 800-978-4334 from 8 a.m. to 7 p.m. ET.

For policy-related questions, contact member.questions@unos.org.

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

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