P128 Transplant patients with HLA allele antibodies need donors typed at that level

Abstract

We are disadvantaging pre and post transplant patients who have potential HLA allele donor specific antibodies (DSAs), when deceased donors are not typed an intermediate or high resolution. How can we estimate the antibody mediated rejection risk (AMR), when we can’t tell if an allele antibody is a DSA? With RT-PCR, SSP and rSSO, we have the ability to type donors in 3–6 h at intermediate to near allele level, why isn’t this level required, it is often needed? Forty-eight percent of my kidney waitlist active patients have HLA antibodies, seventy-eight percent of these patients have some allele antibodies. About twenty-five percent of our virtual and prospective crossmatches involve interpreting potential allele DSAs. Fortunately, Our OPO provides most organ offers with intermediate HLA typing and the typing data, which frequently has enabled an accurate identification of DSAs, and a better estimation of the risk of AMR. An example of how intermediate donor typing, with a patient’s single antigen profile can help identify DSAs:identify DSAs: Download : Download high-res image (91KB) Download : Download full-size image We need to require donor typing at near allele level, to provide pre and post transplant patients better AMR risk assessment and access to transplantation. S.S. Geier: Consultant; Company/Organization; Consulting Director LABSNE, Gift of Life OPO HLA Lab. Scientific/Medical Advisor; Company/Organization; Donor Alliance OPO Advisor Board member. Employee; Company/Organization; Temple University Hospital and Lewis Katz School of Medicine, Director Immunogenetics Lab. Other (Identify); Company/Organization; 2016 UNOS Region 2 representative to the Histo Committee.