Transplant professionals received the following email from Charles Alexander, President of the OPTN/UNOS Board of Directors and Dr. John Lake, Chair of the Membership and Professional Standards Committee on Friday May 13.
To: Transplant Program Directors, Transplant Program Administrators, Transplant Surgeons, Transplant Physicians, Quality Review Officers, Compliance Officers, CEOs of Transplant Hospitals, OPO Medical Directors, OPO Executive Directors and Histocompatibility Laboratory Directors
From: Charles E. Alexander, RN, MSN, M.B.A., CPTC
President, OPTN/UNOS Board of Directors
John R. Lake, M.D.
Chair, Membership and Professional Standards Committee
Subject: Double Verification of ABO Subtypes in Any Donor Prior to Use in an Incompatible Transplant
Although this proposal is currently in the public comment stage, if you are performing ABO subtyping, we recommend that you consider adopting double verification of donor ABO subtyping immediately.
The current Public Comment document, Item #9 https://optn.transplant.hrsa.gov/policies-bylaws/public-comment/ would require OPOs or transplant centers to confirm subtype testing of blood group A and AB on deceased or living donors when subtyping is used to place organs, and the donor is identified as subtype non-A1 (e.g A2) or non-A1B (e.g A2B). The proposed change would specifically require OPOs or transplant centers to take blood samples on two separate occasions—first to test the initial subtype, then again to confirm it. Both samples should be pre-transfusion specimens only.
An increase in the reporting of the incorrect ABO subtyping for living and deceased organ donors that could lead to an unintended incompatible transplant is concerning and preventable. Every transplant professional is obligated to secure an accurate and verified ABO subtype before proceeding with an incompatible organ transplant.
Please share this information with staff at your institution as appropriate.
Link to OPTN public comment page updated Jan. 2023