Histocompatibility Committee Fall 2016

Recent Public Comment Proposals Adding DQA1 Equivalency Table This proposal adds an HLA DQA1 equivalency table to policy that identifies the relationship between parent antigens and corresponding allelic subtypes. Board approved & pending implementation – target date is first quarter 2017

Policy Implementation Dates Histo Bylaws Rewrite: Phase 2 This proposal added the general supervisor to the list of laboratory key personnel. BOD approved, IT programming complete, waiting for OMB approval of forms (membership applications) before implementation. 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 menus to Dr51, Dr52, Dr53 BOD approved, pending implementation, target date is second quarter of 2017

Committee Projects Histo Testing Guidance Document Result of Comprehensive Histocompatibility Rewrite project. Moves 28 sections of old policies and bylaws into a guidance document for member labs. Guidance document in final stages of revision. Anticipated submission to BOD for December meeting. Review of HLA Tables 2016 (DPB1) Building an unacceptable antigen tool into policy for DPB1 – Given the complexity and unique attributes of DPB1, this table will function differently than other equivalency tables. Subcommittee reviewing literature on epitopes to determine which ones to include Assessing possibility of developing a computer-assisted tool for helping determining DPB1 compatibility for patients with DPB1 antibody.

Committee Projects Addressing HLA Typing Errors in DonorNet® Committee working on process improvements to reduce/prevent critical HLA typing errors on donors/candidates resulting in incorrect match runs and organ allocation. As a number of “errors” are the result of transcriptional and parent/split calls, subcommittee is finalizing a memo to be sent to all HLA laboratories requesting increased awareness of such errors Subcommittee is reviewing options for programming changes to DonorNet® aimed at reducing errors. Suggestions include: duplicate data entry, “locked” HLA data fields once entry complete, “flags/alerts” to indicate potentially incorrect data.

Committee Projects Changes to KAS CPRA and Priority for Patients Undergoing Desensitization Building into KAS the ability for patients to maintain PRA priority points when undergoing a desensitization protocol Preliminary survey results showed favorable support for this concept Committee to determine what data to request to best define the problem and submit the project to the POC for approval

Questions? Robert Bray, PhD Committee Chair rbray@emory.edu Robert Hunter Committee Liaison robert.hunter@unos.org