Histocompatibility Committee Spring 2017

Policy Implementation Dates Adding DQA1 Equivalency Table (2016) Identifies relationship between parent unacceptable antigens and corresponding allelic subtypes Implementation: second quarter 2017 Annual Update to Equivalency Tables (2015) Adds alleles to HLA antigen dropdown options in UNet Changes HLA-DPB, HLA-DQA, and HLA-DQB references in policy to HLA-DPB1, HLA-DQA1, and HLA-DQB1 Adds dropdown values to DR51, DR52, DR53 While implementing the Expanding HLA Typing policy, the Histocompatibility Committee became aware of a programming change that allowed for candidate and incompatible donor matching, so the Committee added a DQA1 equivalency table to policy to prevent this from happening. Once implemented, if the parent value is reported as an unacceptable antigen the corresponding subtypes will be automatically excluded. IT is currently implementing the DQA1 equivalency table project along with the Annual Update to Equivalency Tables (2015). They are currently working on programming logistics. Both projects are expected to be completed during second quarter 2017 and will be released together.

Committee Projects – Public Comment Guidance Document Clarifies OPTN bylaws and policies regarding histocompatibility testing Intended to be used by histocompatibility labs Distributed for public comment: January 2017 Projected to go to the Board June 2017 Guidance Document: After making substantial revisions and edits throughout the year, the committee approved a final version of the guidance document to go out for public comment in January 2017. The proposed guidance document is intended to help histocompatibility labs comply with OPTN policies and bylaws with regard to histocompatibility testing. Since this is not a policy or bylaw change, we expect it to be non-controversial. It will likely be on the June 2017 board meeting agenda.

Committee Projects – In Development Addressing HLA Typing Errors in DonorNet® UNOS sent letters to 14 labs to prevent future errors Considering programming options Review of HLA Equivalency Tables (2016) Creating a DPB1 resource Subcommittee reviewed epitopes Continuing to work on developing tool by researching data sources HLA Typing Errors: The Committee continues to address discrepant HLA typing errors. They identified those labs having a certain percentage of critical errors and mailed those labs letters in October 2016. These letters were educational - not punitive - and the content encouraged labs to provide feedback on ways to prevent these errors from happening in the future. The Committee is working with IT to develop programming solutions to help prevent discrepant typing errors. Review of HLA Tables 2016 DPB1: The Committee and Subcommittee will continue to work on developing a resource for DPB1 antigens. The Subcommittee has reviewed largely agreed upon epitopes and is working on next steps.

Questions? Robert Bray, Ph.D., D(ABHI), HCLD/CC(ABB) Committee Chair rbray@emory.edu Alison Wilhelm Committee Liaison alison.wilhelm@unos.org