Recommendations From the Implementation Steering Group for Organ Utilisation Histocompatibility and Immunogenetics Sub-Group: ISOU H&I Sub-Group Recommendations.

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.