Eurotransplant Annual Meeting 2015 magazine | Page 16

Eurotransplant Annual Meeting 2015 overview on these groups is a challenge; due to many unknown factors (unknown referral rates, not registered for transplantation). However, there are several documented cases and studies on how to deal with this group of donors and recipients. There are no specific guidelines and protocols for this patient group. The current view is that there needs to be an independent group that decides on donation and transplantation per individual case, based on the legal system per country. _______________________________________________________________________________________________ Tissue Typers meeting Chair: F. Claas Speakers: Y. Zoet, S. Heidt, F. Claas, S. Schaub Report by: S. Heidt Mrs. Zoet opened the tissue typers meeting with an overview of the ETRL external proficiency testing (EPT) results from 2015. These included results from HLA typing, crossmatching, as well as HLA antibody screening and identification assays. Discrepancy rates for all exercises were similar to those of previous years. New features and adaptations to the EPT website were also shown, as well as the new format of the EPT certificates. Dr. Heidt presented data on two pilots of patient-based EPT exercises that were conducted this year. The first pilot was a paper-based case in which all relevant histocompatibility data from a patient and candidate donor were provided to the participating tissue typing laboratories. These were asked to send in their advice on whether the transplant could go ahead on immunological grounds. The second pilot was a sample-based exercise in which regular EPT serum and cells were selected as virtual patient – donor combinations. Both pilots resulted in great heterogeneity in the advice given, which warrants the inclusion of paper-based EPT exercises as part of the mandatory EPT scheme. The results will be discussed in detail at the extra mural meetings. Prof. Claas showed preliminary data from the Eurostam consortium study. This is a European Union-sponsored study on the feasibility of developing a Europe-wide Acceptable Mismatch (AM) program. Data from the Eurotransplant AM program showed that a proportion of patients still does not receive a kidney transplant, despite being included in the AM program. These patients usually have an uncommon HLA phenotype when looking into the Eurotransplant donor population. Data from the Eurotransplant consortium presented at the tissue typers meeting clearly showed that there is a benefit for many of these patients to be put on the waiting list of another allocation program within Europe. Finally, Dr. Schaub from Basel, Switzerland held an interactive lecture on the relevance of antibodies detected by Luminex only. By showing three patient cases with unexpected transplant outcome (based on antibody characterization), he made clear that there is more to HLA antibodies than MFI. Dr. Schaub showed that non-HLA antibodies, the presence of B cell memory, the HLA density on the target tissue, antibody characteristics, as well as protective factors all play a role in the outcome of an organ transplant. Report Annual Meeting 2015 | Eurotransplant 16