Recommendations From the Implementation Steering Group for Organ Utilisation Histocompatibility and Immunogenetics...

The Organ Utilisation Group was established to address barriers in solid organ transplantation and improve patient outcomes across the United Kingdom. The group produced a series of recommendations in February 2023. To address these recommendations, the Department of Health and Social Care formed the Implementation Steering Group for Organ Utilisation (ISOU). A dedicated Histocompatibility and Immunogenetics (H&I) sub-group was formed with a remit to provide recommendations for HLA compatibility assessments and new technologies that could improve patient outcomes, within a 5 to 10 year time frame. The ISOU H&I sub-group made five key recommendations, grouped under three themes: (1) implementation and digital capture of high-resolution HLA typing data for organ donor and recipients; (2) utilising high-resolution HLA typing data to improve donor/recipient compatibility assessment and patient outcomes and (3) use of other technologies/innovations to improve patient outcomes. This article discusses the recommendations with an emphasis on advanced technologies and methodologies such as high-resolution HLA typing, molecular matching, non-HLA antigen systems, donor-derived cell-free DNA (dd-cfDNA) and artificial intelligence (AI). Implementation of these recommendations aims to enhance organ matching, reduce immunological risk and improve equity and long-term outcomes for transplant recipients and position UK transplantation services at the forefront of innovation and patient-centred care.