Solid Organ Transplantation (SLS143)

10 credits

Aim of this module

This module will provide the trainee with knowledge and understanding of the mechanism of hypersensitivity and allergy. They will understand the clinical presentation and investigation of a range of conditions associated with hypersensitivity and allergy. They will become familiar with methods and strategies to investigate hypersensitivity and allergy and gain experience of the interpretation of patient results in a variety of clinical settings.

This module will provide the trainee with the practical application of knowledge and skills relating to Histocompatibility and Immunogenetics techniques applicable to solid organ transplantation and blood transfusion.

  1. Perform the clinical and laboratory work up of patients awaiting solid organ transplantation, including the interpretation and reporting of results in the correct clinical context.
  2. Assess the suitability of patients for crossmatch and transplantation within the national deceased donor organ allocation scheme.
  3. Analyse and report laboratory tests for donor and recipient compatibility to facilitate transplantation within the national deceased donor organ allocation scheme.
  4. Assess the suitability of patients for crossmatch and transplantation for living donation.
  5. Perform clinical and laboratory monitoring of patients who have received a solid organ transplant.
  6. Work in partnership with other clinical specialisms in the investigation of solid organ transplantation and platelet transfusion and, where appropriate with service users and support staff.
  7. Assess the suitability of patients for HLA/HPA selected platelets and identify compatible platelet units.
Number Work-based learning outcome Title Knowledge
1 1

Assess patients for registration onto the national transplant list and perform the tests necessary to achieve this including:

  • HLA typing
  • HLA antibody detection/definition
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2 1,2,4,5

Interpret data from HLA antibody identification tests and prepare clinically meaningful reports on patients awaiting solid organ transplantation.

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3 1,2,3,4,7

Interpret crossmatch data and produce a crossmatch report for clinical colleagues according to local protocol.

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4 2,3

HLA type a deceased potential donor according to local protocols and complete a donor HLA report form for submission to NHSBT-ODT.

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5 2,3

Assess the suitability of potential kidney/pancreas recipients for a deceased donor organ.

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6 2,3

Assess the suitability of potential cardio thoracic or other solid organ (liver, islets, bowel) recipients for a deceased donor.

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7 2,3,4,7

Analyse crossmatch data for a potential transplant recipient according to local policy and prepare a crossmatch report for clinical colleagues.

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8 2,3,4,7

Perform a virtual crossmatch assessment for a potential transplant recipient according to local policy and prepare a cross-match report for clinical colleagues.

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9 2,3,4,7

Assess the suitability of potential kidney donor/recipients for a living donor transplant and produce an interpretive report for clinical colleagues.

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10 5

Perform tests to detect or monitor donor specific antibodies for post transplant patients.

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11 6

Work in partnership with other clinical specialisms in the investigation of solid organ transplantation and platelet transfusion and, where appropriate with service users and support staff.

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12 6

Communicate effectively with the healthcare team recognising and responding appropriately to situations where it is necessary to share information to safeguard service users or the wider public.

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13 7

Analyse antibody data for a patient referred for platelet refractoriness and produce an interpretive report for clinical colleagues

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14 7

Select appropriate platelet units for patients requiring HLA/Human Platelet Antigen (HPA) selected platelets

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You must complete
2 Case-based discussion(s)
2 of the following DOPS / OCEs
Assessment Title Type
Perform tests for deceased donor recipient crossmatching DOPS
Perform tests for living donor recipient crossmatching DOPS
Prepare a prospective or retrospective crossmatch report DOPS
Perform tests to monitor post-transplant donor specific antibodies DOPS
Perform a virtual crossmatch for deceased or living donation DOPS
HLA type a potential deceased donor DOPS
Prepare a living donor assessment report DOPS
Perform a risk assessment for cardiothoracic donation according to UK guidelines DOPS
Prepare a platelet refractoriness assessment report DOPS
Identify compatible HLA selected platelet units DOPS
Attend ward rounds and/or clinics at which patients are being worked up for, or monitored following solid organ transplantation and describe to the patient the involvement of the Laboratory in their care OCE
Attend a living donor transplant OCE
Attend a multidisciplinary review meeting at which laboratory results are presented. OCE

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning Outcomes

  1. Explain the immunological barriers to solid organ and haematopoietic stem cell transplantation.
  2. Describe the mechanisms of graft rejection and the relevance of pre-sensitisation.
  3. Describe the mechanisms of current immunosuppressive therapies in the control of graft rejection
  4. Discuss the role of the histocompatibility and immunogenetics laboratory in the pre transplant work-up and
    post-transplant management of patients.
  5. Describe the design, operation and performance of appropriate laboratory tests in support of HLA antibody
    identification and definition, HLA typing and data analysis
  6. Describe the design, operation and performance of appropriate laboratory tests in support of cross-matching
    for solid organ transplantation.
  7. Describe the partnership between the histocompatibility and immunogenetics laboratory and other clinical
    specialisms in solid organ and haematopoietic stem cell transplantation and patient care.

Indicative Content

  • Histocompatibility antigens
    • Structure and function
    • Generation of polymorphism
    • Nomenclature
  • Mechanisms of allograft rejection
    • Alloantigen recognition
    • Classification of rejection reactions
    • Graft versus host reactions
    • HLA typing
    • Pre-transplant sensitisation
  • Immunosuppressive therapy
    • Drugs
    • Biological modifiers
    • NICE recommendations
    • Adverse effects of immunosuppressive therapies
  • Clinical transplantation
    • Renal transplantation (selection of recipient and donor; post-transplantation period; clinical rejection;
      immunopathology of rejection; graft survival; complications)
    • Other types of organ transplantation (liver; heart; lung; pancreas; pancreatic islets; skin; cornea)
    • Haematopoietic stem cell transplantation (indications and selection of patients; donor–recipient
      matching requirements; management; complications and prevention; results and prognosis; sources of
      stem cells for transplantation; stem cell transplantation for non-malignant indications)