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

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Title: Recommendations From the Implementation Steering Group for Organ Utilisation Histocompatibility and Immunogenetics Sub-Group: ISOU H&I Sub-Group Recommendations.
Authors: Speirs NC; H&I Laboratory, SNBTS, Edinburgh Royal Infirmary, NHS National Services Scotland, Edinburgh, UK., Chalker V; NHS England, London, UK., Clark B; Leeds Teaching Hospitals NHS Trust, Leeds, UK., Courtney AE; Regional Nephrology & Transplant Unit, Belfast City Hospital, Belfast, UK., Daga S; Leeds Teaching Hospitals NHS Trust, Leeds, UK.; University of Leeds, Leeds, UK., Griffin S; Cardiff and Vale University Health Board, Cardiff, UK., Kallon D; Clinical Transplantation Laboratory, NHS East and South East London Pathology Partnership, Barts Health NHS Trust, London, UK., Kim JJ; Department of Surgery, University of Cambridge, Cambridge, UK.; Department of Paediatric Nephrology, Nottingham University Hospital, Nottingham, UK., Kosmoliaptsis V; Department of Surgery, University of Cambridge, Cambridge, UK.; NIHR Blood and Transplant Research Unit in Organ Donation and Transplantation, University of Cambridge, Cambridge, UK., Latham K; NHS Blood and Transplant, London, UK., Peacock S; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Shaw O; Clinical Transplantation Laboratory, Guys Hospital, Synnovis, London, UK., Nieto T; Department of Renal Transplant Surgery, Queen Elizabeth Hospital, Birmingham, UK., Ravanan R; North Bristol NHS Trust, Bristol, UK., Battle R; H&I Laboratory, SNBTS, Edinburgh Royal Infirmary, NHS National Services Scotland, Edinburgh, UK.
Source: International journal of immunogenetics [Int J Immunogenet] 2026 Aug; Vol. 53 (4), pp. 324-331. Date of Electronic Publication: 2026 May 14.
Publication Type: Journal Article; Review
Language: English
Journal Info: Publisher: Blackwell Pub Country of Publication: England NLM ID: 101232337 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1744-313X (Electronic) Linking ISSN: 17443121 NLM ISO Abbreviation: Int J Immunogenet Subsets: MEDLINE
Imprint Name(s): Original Publication: Oxford, UK : Blackwell Pub., c2005-
MeSH Terms: Histocompatibility Testing*/methods , Histocompatibility Testing*/standards , Immunogenetics*/methods , HLA Antigens*/immunology , HLA Antigens*/genetics , Histocompatibility*/genetics , Histocompatibility*/immunology , Organ Transplantation* , Tissue and Organ Procurement*, Humans ; United Kingdom ; Tissue Donors
Abstract: 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.
(© 2026 John Wiley & Sons Ltd.)
References: Biomedicines. 2025 Jul 07;13(7):. (PMID: 40722731)
J Immunol. 2018 Dec 15;201(12):3780-3792. (PMID: 30429288)
Am J Transplant. 2024 Jul;24(7):1218-1232. (PMID: 38403189)
Curr Opin Organ Transplant. 2019 Aug;24(4):370-377. (PMID: 31135563)
Curr Opin Organ Transplant. 2018 Aug;23(4):477-485. (PMID: 29870434)
BMJ. 2019 Sep 17;366:l4923. (PMID: 31530561)
Med Princ Pract. 2024;33(3):215-231. (PMID: 38442703)
Am J Transplant. 2023 Jan;23(1):133-149. (PMID: 36695615)
HLA. 2024 Mar;103(3):e15441. (PMID: 38507216)
HLA. 2020 Jul;96(1):43-51. (PMID: 32227681)
Hum Immunol. 2020 Aug;81(8):413-422. (PMID: 32595056)
Curr Res Transl Med. 2025 Apr-Jun;73(2):103493. (PMID: 39792149)
Transplantation. 2023 Mar 1;107(3):605-615. (PMID: 36163639)
Am J Transplant. 2017 Dec;17(12):3149-3158. (PMID: 28597555)
Transpl Int. 2022 Jul 04;35:10640. (PMID: 35859667)
Front Immunol. 2022 Sep 29;13:924825. (PMID: 36248818)
Transpl Int. 2025 Aug 13;38:14716. (PMID: 40881320)
Transpl Immunol. 2023 Dec;81:101905. (PMID: 37541630)
Am J Transplant. 2020 Dec;20(12):3367-3378. (PMID: 32337773)
Int J Immunogenet. 2023 Nov;50 Suppl 2:3-63. (PMID: 37919251)
Transplant Rev (Orlando). 2020 Apr;34(2):100533. (PMID: 32007300)
Am J Kidney Dis. 2025 Mar;85(3):364-374. (PMID: 39419272)
Front Immunol. 2011 Nov 08;2:59. (PMID: 22566848)
Biomark Med. 2022 Apr;16(5):401-415. (PMID: 35195028)
Nat Med. 2024 Aug;30(8):2320-2327. (PMID: 38824959)
Am J Transplant. 2021 Jan;21(1):344-352. (PMID: 32430947)
Kidney Int Rep. 2024 May 04;9(6):1568-1570. (PMID: 38899192)
J Clin Med. 2025 Apr 17;14(8):. (PMID: 40283605)
HLA. 2020 Aug;96(2):141-162. (PMID: 32274854)
J Transl Med. 2025 Jun 18;23(1):678. (PMID: 40533820)
Transplantation. 2024 Sep 1;108(9):1994-2004. (PMID: 38595232)
Front Genet. 2022 Oct 21;13:1031894. (PMID: 36339004)
Transpl Int. 2024 Jun 11;37:12445. (PMID: 38962472)
Hum Immunol. 2013 Mar;74(3):290-6. (PMID: 23232063)
Nat Med. 2025 Jul;31(7):2161-2173. (PMID: 40659768)
Tissue Antigens. 2010 Apr;75(4):291-455. (PMID: 20356336)
Front Transplant. 2024 Mar 15;3:1361491. (PMID: 38993779)
Am J Transplant. 2016 Jul;16(7):2139-47. (PMID: 26755448)
Transpl Int. 2024 Jan 04;36:12115. (PMID: 38239762)
Am J Transplant. 2025 Jun;25(6):1226-1234. (PMID: 39631566)
Transpl Int. 2023 Sep 04;36:11641. (PMID: 37727386)
Contributed Indexing: Keywords: HLA; ISOU; dd‐cfDNA; recommendations
Substance Nomenclature: 0 (HLA Antigens)
Entry Date(s): Date Created: 20260514 Date Completed: 20260710 Latest Revision: 20260813
Update Code: 20260813
PubMed Central ID: PMC13352101
DOI: 10.1111/iji.70054
PMID: 42132187
Database: MEDLINE
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  Data: Recommendations From the Implementation Steering Group for Organ Utilisation Histocompatibility and Immunogenetics Sub-Group: ISOU H&I Sub-Group Recommendations.
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  Data: <searchLink fieldCode="AU" term="%22Speirs+NC%22">Speirs NC</searchLink>; H&I Laboratory, SNBTS, Edinburgh Royal Infirmary, NHS National Services Scotland, Edinburgh, UK.<br /><searchLink fieldCode="AU" term="%22Chalker+V%22">Chalker V</searchLink>; NHS England, London, UK.<br /><searchLink fieldCode="AU" term="%22Clark+B%22">Clark B</searchLink>; Leeds Teaching Hospitals NHS Trust, Leeds, UK.<br /><searchLink fieldCode="AU" term="%22Courtney+AE%22">Courtney AE</searchLink>; Regional Nephrology & Transplant Unit, Belfast City Hospital, Belfast, UK.<br /><searchLink fieldCode="AU" term="%22Daga+S%22">Daga S</searchLink>; Leeds Teaching Hospitals NHS Trust, Leeds, UK.; University of Leeds, Leeds, UK.<br /><searchLink fieldCode="AU" term="%22Griffin+S%22">Griffin S</searchLink>; Cardiff and Vale University Health Board, Cardiff, UK.<br /><searchLink fieldCode="AU" term="%22Kallon+D%22">Kallon D</searchLink>; Clinical Transplantation Laboratory, NHS East and South East London Pathology Partnership, Barts Health NHS Trust, London, UK.<br /><searchLink fieldCode="AU" term="%22Kim+JJ%22">Kim JJ</searchLink>; Department of Surgery, University of Cambridge, Cambridge, UK.; Department of Paediatric Nephrology, Nottingham University Hospital, Nottingham, UK.<br /><searchLink fieldCode="AU" term="%22Kosmoliaptsis+V%22">Kosmoliaptsis V</searchLink>; Department of Surgery, University of Cambridge, Cambridge, UK.; NIHR Blood and Transplant Research Unit in Organ Donation and Transplantation, University of Cambridge, Cambridge, UK.<br /><searchLink fieldCode="AU" term="%22Latham+K%22">Latham K</searchLink>; NHS Blood and Transplant, London, UK.<br /><searchLink fieldCode="AU" term="%22Peacock+S%22">Peacock S</searchLink>; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.<br /><searchLink fieldCode="AU" term="%22Shaw+O%22">Shaw O</searchLink>; Clinical Transplantation Laboratory, Guys Hospital, Synnovis, London, UK.<br /><searchLink fieldCode="AU" term="%22Nieto+T%22">Nieto T</searchLink>; Department of Renal Transplant Surgery, Queen Elizabeth Hospital, Birmingham, UK.<br /><searchLink fieldCode="AU" term="%22Ravanan+R%22">Ravanan R</searchLink>; North Bristol NHS Trust, Bristol, UK.<br /><searchLink fieldCode="AU" term="%22Battle+R%22">Battle R</searchLink>; H&I Laboratory, SNBTS, Edinburgh Royal Infirmary, NHS National Services Scotland, Edinburgh, UK.
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  Data: <searchLink fieldCode="JN" term="%22101232337%22">International journal of immunogenetics</searchLink> [Int J Immunogenet] 2026 Aug; Vol. 53 (4), pp. 324-331. <i>Date of Electronic Publication: </i>2026 May 14.
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  Data: 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.<br /> (© 2026 John Wiley & Sons Ltd.)
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  Data: Biomedicines. 2025 Jul 07;13(7):. (PMID: <searchLink fieldCode="PM" term="%2240722731%22">40722731)</searchLink><br />J Immunol. 2018 Dec 15;201(12):3780-3792. (PMID: <searchLink fieldCode="PM" term="%2230429288%22">30429288)</searchLink><br />Am J Transplant. 2024 Jul;24(7):1218-1232. (PMID: <searchLink fieldCode="PM" term="%2238403189%22">38403189)</searchLink><br />Curr Opin Organ Transplant. 2019 Aug;24(4):370-377. (PMID: <searchLink fieldCode="PM" term="%2231135563%22">31135563)</searchLink><br />Curr Opin Organ Transplant. 2018 Aug;23(4):477-485. (PMID: <searchLink fieldCode="PM" term="%2229870434%22">29870434)</searchLink><br />BMJ. 2019 Sep 17;366:l4923. (PMID: <searchLink fieldCode="PM" term="%2231530561%22">31530561)</searchLink><br />Med Princ Pract. 2024;33(3):215-231. (PMID: <searchLink fieldCode="PM" term="%2238442703%22">38442703)</searchLink><br />Am J Transplant. 2023 Jan;23(1):133-149. (PMID: <searchLink fieldCode="PM" term="%2236695615%22">36695615)</searchLink><br />HLA. 2024 Mar;103(3):e15441. (PMID: <searchLink fieldCode="PM" term="%2238507216%22">38507216)</searchLink><br />HLA. 2020 Jul;96(1):43-51. (PMID: <searchLink fieldCode="PM" term="%2232227681%22">32227681)</searchLink><br />Hum Immunol. 2020 Aug;81(8):413-422. (PMID: <searchLink fieldCode="PM" term="%2232595056%22">32595056)</searchLink><br />Curr Res Transl Med. 2025 Apr-Jun;73(2):103493. (PMID: <searchLink fieldCode="PM" term="%2239792149%22">39792149)</searchLink><br />Transplantation. 2023 Mar 1;107(3):605-615. (PMID: <searchLink fieldCode="PM" term="%2236163639%22">36163639)</searchLink><br />Am J Transplant. 2017 Dec;17(12):3149-3158. (PMID: <searchLink fieldCode="PM" term="%2228597555%22">28597555)</searchLink><br />Transpl Int. 2022 Jul 04;35:10640. (PMID: <searchLink fieldCode="PM" term="%2235859667%22">35859667)</searchLink><br />Front Immunol. 2022 Sep 29;13:924825. (PMID: <searchLink fieldCode="PM" term="%2236248818%22">36248818)</searchLink><br />Transpl Int. 2025 Aug 13;38:14716. (PMID: <searchLink fieldCode="PM" term="%2240881320%22">40881320)</searchLink><br />Transpl Immunol. 2023 Dec;81:101905. (PMID: <searchLink fieldCode="PM" term="%2237541630%22">37541630)</searchLink><br />Am J Transplant. 2020 Dec;20(12):3367-3378. (PMID: <searchLink fieldCode="PM" term="%2232337773%22">32337773)</searchLink><br />Int J Immunogenet. 2023 Nov;50 Suppl 2:3-63. (PMID: <searchLink fieldCode="PM" term="%2237919251%22">37919251)</searchLink><br />Transplant Rev (Orlando). 2020 Apr;34(2):100533. (PMID: <searchLink fieldCode="PM" term="%2232007300%22">32007300)</searchLink><br />Am J Kidney Dis. 2025 Mar;85(3):364-374. (PMID: <searchLink fieldCode="PM" term="%2239419272%22">39419272)</searchLink><br />Front Immunol. 2011 Nov 08;2:59. (PMID: <searchLink fieldCode="PM" term="%2222566848%22">22566848)</searchLink><br />Biomark Med. 2022 Apr;16(5):401-415. (PMID: <searchLink fieldCode="PM" term="%2235195028%22">35195028)</searchLink><br />Nat Med. 2024 Aug;30(8):2320-2327. (PMID: <searchLink fieldCode="PM" term="%2238824959%22">38824959)</searchLink><br />Am J Transplant. 2021 Jan;21(1):344-352. (PMID: <searchLink fieldCode="PM" term="%2232430947%22">32430947)</searchLink><br />Kidney Int Rep. 2024 May 04;9(6):1568-1570. (PMID: <searchLink fieldCode="PM" term="%2238899192%22">38899192)</searchLink><br />J Clin Med. 2025 Apr 17;14(8):. (PMID: <searchLink fieldCode="PM" term="%2240283605%22">40283605)</searchLink><br />HLA. 2020 Aug;96(2):141-162. (PMID: <searchLink fieldCode="PM" term="%2232274854%22">32274854)</searchLink><br />J Transl Med. 2025 Jun 18;23(1):678. (PMID: <searchLink fieldCode="PM" term="%2240533820%22">40533820)</searchLink><br />Transplantation. 2024 Sep 1;108(9):1994-2004. (PMID: <searchLink fieldCode="PM" term="%2238595232%22">38595232)</searchLink><br />Front Genet. 2022 Oct 21;13:1031894. (PMID: <searchLink fieldCode="PM" term="%2236339004%22">36339004)</searchLink><br />Transpl Int. 2024 Jun 11;37:12445. (PMID: <searchLink fieldCode="PM" term="%2238962472%22">38962472)</searchLink><br />Hum Immunol. 2013 Mar;74(3):290-6. (PMID: <searchLink fieldCode="PM" term="%2223232063%22">23232063)</searchLink><br />Nat Med. 2025 Jul;31(7):2161-2173. (PMID: <searchLink fieldCode="PM" term="%2240659768%22">40659768)</searchLink><br />Tissue Antigens. 2010 Apr;75(4):291-455. (PMID: <searchLink fieldCode="PM" term="%2220356336%22">20356336)</searchLink><br />Front Transplant. 2024 Mar 15;3:1361491. (PMID: <searchLink fieldCode="PM" term="%2238993779%22">38993779)</searchLink><br />Am J Transplant. 2016 Jul;16(7):2139-47. (PMID: <searchLink fieldCode="PM" term="%2226755448%22">26755448)</searchLink><br />Transpl Int. 2024 Jan 04;36:12115. (PMID: <searchLink fieldCode="PM" term="%2238239762%22">38239762)</searchLink><br />Am J Transplant. 2025 Jun;25(6):1226-1234. (PMID: <searchLink fieldCode="PM" term="%2239631566%22">39631566)</searchLink><br />Transpl Int. 2023 Sep 04;36:11641. (PMID: <searchLink fieldCode="PM" term="%2237727386%22">37727386)</searchLink>
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      – SubjectFull: Humans
        Type: general
      – SubjectFull: United Kingdom
        Type: general
      – SubjectFull: Tissue Donors
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      – TitleFull: Recommendations From the Implementation Steering Group for Organ Utilisation Histocompatibility and Immunogenetics Sub-Group: ISOU H&I Sub-Group Recommendations.
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            NameFull: Battle R
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      – BibEntity:
          Dates:
            – D: 01
              M: 08
              Text: 2026 Aug
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-electronic
              Value: 1744-313X
          Numbering:
            – Type: volume
              Value: 53
            – Type: issue
              Value: 4
          Titles:
            – TitleFull: International journal of immunogenetics
              Type: main
ResultId 1