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HLA Equivalency Tables Update 2020

Proposal Overview

Status: Public Comment

Sponsoring Committee: Histocompatibility

Strategic Goal: Improve waitlisted patient, living donor, and transplant recipient outcomes

Read the proposal (PDF; 01/2020)

View the Board Briefing Paper (PDF; 06/2020)

Contact: Betsy Gans

eye iconAt a glance

What is current policy and why change it?

Histocompatibility laboratories use commercially available kits to test transplant recipient and potential organ donor tissues for compatibility. This matching helps lower the risk that the recipient’s body will reject the transplant. The values used in this testing are included in tables in OPTN policy, so these values can be programmed into the OPTN computer system. As the science changes, the values used in the test kits need to be updated. This proposal updates the tables and adds an additional table with a new element that can further improve efficiency of tissue matching.   

What’s the proposal?

  • Updates to existing reference tables in OPTN Policy 4.10: Reference Tables of HLA Antigen Values and Split Equivalences.
  • Add new reference tables to be programmed into the OPTN computer systems, including the option for transplant hospital or histocompatibility labs to use an additional method that may make it easier to match candidate and donor tissue.
  • Set up future updates to these tables to go through an expedited policy process which allows these routine updates to be made quickly.

What’s the anticipated impact of this change?

  • What it’s expected to do
    • Update the existing reference tables to match the updated test kits.
    • Add an option to use a new element that can provide easier and more-efficient matching.
    • Shorten the length of time required to routinely update the reference tables.
  • What it won’t do
    • Change the Calculated Panel Reactive Antibodies (CPRA) calculation or frequency data used for the calculation.

Themes to consider

  •  Appropriateness of using expedited process for future updates.
  •  Addition of optional new element that increases efficiency and makes it easier to match tissues.

Terms you need to know

  • Calculated Panel Reactive Antibodies – Calculation that shows the percentage chance a recipient will not match with a donor’s tissue.  The higher the percentage the more “sensitized” a recipient is.
  • Human leukocyte antigen (HLA) complex – a group of genes that helps the immune system distinguish the body's own proteins from proteins made by foreign invaders such as viruses and bacteria.
  •  Click here to search the OPTN glossary.

The comment period for this proposal is now closed.