Require Human Leukocyte Antigen (HLA) Confirmatory Typing for Deceased Donors

At a glance

Current policy

Current policy requires that histocompatibility labs perform Human Leukocyte Antigen (HLA) typing on deceased kidney and pancreas donors to make sure the recipient and the organ are compatible. This is required for all other organs upon request of the transplant hospital. However, there can be rare instances where the test results are incorrect due to assay or laboratory error and the recipient and the organ are not compatible. The Histocompatibility Committee proposes requiring labs to perform two HLA typing tests on deceased donors to help prevent these errors.

Supporting media

Presentation

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Proposed changes

Require labs to perform two HLA typings from deceased donors.
- The two tests must be drawn from two different samples, at two different times.
The lab must provide the results of these tests according to the terms in their contract with the OPO.

Anticipated impact

What it's expected to do
- Improve transplant recipient safety by ensuring they are receiving a compatible organ
- Improve transplant recipient outcomes by preventing the need for an immediate second transplant due to the first transplant being incompatible

What it won't do
- There are no changes for which organs HLA typing is required
- There are no changes for the timing of the required HLA typings

Terms to know

Human leukocyte antigen (HLA): Proteins on the cell surface that differentiate between self and non-self.
Sensitization: Transplant candidates are "sensitized" if their immune system makes antibodies against one or more HLA antigens or alleles in the donor pool. Sensitization usually occurs as a consequence of pregnancy, blood transfusions, or previous transplantation. Highly sensitized patients are less likely to match with available donors and more likely to reject an organ than unsensitized patients.
Histocompatibility Laboratory: A member of the OPTN. A lab that performs immunologic testing, including but not limited to, Human Leukocyte Antigen (HLA) typing, antibody screening, or crossmatching, and serves at least one transplant hospital member or OPO.
Deceased donors: An individual from whom at least one organ is recovered for the purpose of transplantation after declaration of death.