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Require Notification of Human Leukocyte Antigen (HLA) Typing Changes

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eye iconAt a glance

Current policy

Histocompatibility laboratories test compatibility of transplant candidate and organ donor tissues using the human leukocyte antigen (HLA) complex. This process is also known as HLA typing. When a candidate is more compatible with the donor, there is less risk the candidate’s body will reject the transplant.

There is no current requirement to communicate HLA typing changes to transplant programs or Organ Procurement Organizations (OPOs). Patient safety is at risk when transplant programs are not aware of HLA typing changes.

Supporting media


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Proposed changes

  • Require notifications when there is a critical change to candidate, recipient, or donor HLA typing.
    • Histocompatibility labs must notify the OPO within one hour of determining the correct typing for a donor and provide documentation of the corrected typing.
    • After receiving the correct documentation from the histocompatibility lab, the OPO will be required to notify all accepting transplant programs and provide documentation within 12 hours. If the discrepancy is discovered before organ recovery, the OPO will be required to notify accepting transplant programs.
    • If a histocompatibility lab becomes aware of a discrepancy in a candidate or recipient’s HLA typing, they will notify the transplant program within five days of determining the correct typing and provide documentation of the corrected typing.

Anticipated impact

  • What it's expected to do
    • Improve patient safety by requiring notification when there is a critical change in a donor, candidate or recipient’s HLA.
  • What it won't do
    • Change required HLA testing


  • Patient safety
  • Communication among histocompatibility labs, transplant programs, and OPOs

Terms to know

  • Donor Histocompatibility Form: The form submitted by the histocompatibility laboratory containing HLA information of a deceased donor or living donor.
  • Histocompatibility: The examination of HLA in a patient, often referred to as "tissue typing" or "genetic matching." Tissue typing is routinely performed for all donors and transplant candidates to help match the donor with the most suitable recipients to help decrease the likelihood of rejecting the transplanted organ.
  • Human leukocyte antigen (HLA) complex: a group of proteins that helps the immune system distinguish the body's own cells from foreign invaders such as viruses and bacteria.
  • Organ Procurement Organization: An organization responsible for the recovery of organs for transplantation and the promotion of organ donation. OPOs serve as the vital link between the donor and recipient and are responsible for the identification of donors, and the retrieval, preservation and transportation of organs for transplantation.
  • Transplant program: A component within a transplant hospital that provides transplantation of a particular type of organ
  • Click here to search the OPTN glossary

eye iconComments

University of Illinois Chicago | 01/21/2021

Any change in deceased donor HLA typing performed by OPO must be communicated to transplant laboratories ASAP as this impacts risk assessment and post-transplant DSA monitoring. Currently we do not accept organs without a physical cross match. However, if we decide to accept organs based on virtual cross match for sensitized recipients, expeditious accurate donor typing is critical. This proposal brings to light the possibility of error in donor HLA typing and the risk associated with a virtual cross match.

Region 4 | 02/04/2021

Region 4 sentiment: 3 strongly support; 12 support; 2 neutral/abstain; 0 oppose; 0 strongly oppose. Region 4 had no comments for this proposal.

Region 3 | 02/18/2021

Region 3 sentiment: Strongly support-1, Support-15, Neutral/abstain- 1, Oppose - 0, Strongly Oppose – 0. This was not discussed during the meeting but OPTN representatives were able to submit comments with their sentiment. A member recommended 1 hour and 24 hour notification timelines consistent with OPTN policies 5.5 and 15.4.

Region 5 | 02/19/2021

Region 5 sentiment: 3 strongly support, 20 support, 2 neutral/abstain, 0 oppose, 0 strongly oppose. No comments or questions

ANNA | 02/25/2021

ANNA supports this proposal.