Scottish Donation and Transplant Group written update: August 2025

Histocompatibility and Immunogenetics (HI) support for transplantation in Scotland

Update given by:

• Dr David Turner, Consultant Clinical Scientist, Scottish National Blood Transfusion Service 
• Dr Ann-Margaret Little, Consultant Clinical Scientist, NHS Greater Glasgow and Clyde

Staffing 

Glasgow HI: The Consultant Clinical Scientist in Glasgow has recently retired.  Interviews planned for replacement.

Edinburgh HI: Full establishment. Bid for monies to NHS National Services Scotland for a Band seven post for development of HI Healthcare Scientists to take the Royal College of Pathology (RCPath) exams was successful. The post being recruited to. 

Scottish National Blood Transfusion Service (SNBTS) Edinburgh HI Service Level Agreement discussions with NHS Lothian and National Services Directorate (NSD)

On 8 April 2025, Dave Turner received an email from NSD querying changes to HI staffing being cross-charged to NHS Lothian to cover renal transplant work. Within the NSD terms and agreement for renal transplant work there is a provision for HI staffing, that no longer reflects the HI workforce employed by SNBTS to provide HI services. A business case to NSD has been completed by SNBTS HI to ensure appropriate funding is provided to NHS Lothian to enable cross-charging by SNBTS for all transplant work. This has been sent to NHS Lothian for approval and to NSD.

On call rotas

The consultant/principal clinical scientist rota supporting deceased donor kidney, Simultaneous Pancreas-Kidney (SPK), islet and cardiac transplantation in Scotland continues as a 1:4. No issues with biomedical scientist/clinical scientist rota for on call laboratory work.

Donor Human Leukocyte Antigen (HLA) typing

Since April 2022 this service is commissioned and funded by NHS Blood and Transplant (NHSBT) in England. In devolved areas of the UK, HI and microbiology laboratories are not funded centrally from NHSBT, but are obliged to sign a contract to agree to key performance indicators (KPIs).

KPI for HLA types being reported within four hours of sample receipt (target = 90%).

Donor Characterisation Electronic Results Transfer (DCERT)

NHSBT are introducing electronic reporting of deceased donor HLA types to the Organ and Tissue Donation and Transplantation (OTDT) Directorate to avoid transcription errors. The latest available figures for anomalies in donor HLA typing show that no anomalies were identified post organ allocation in 2024. Roll out of electronic reporting for both Glasgow and Edinburgh laboratories is now planned for later in 2025. Edinburgh are awaiting an update to a third-party piece of software.

Human Leukocyte Antigen-incompatible (HLAi) transplants facilitated by Imlifidase

Patients at both sites have had ‘unacceptable’ antigens removed to increase offers of HLA incompatible grafts that may require the use of Imlifidase. The first Imlifidase facilitated kidney transplant in Scotland went ahead in Edinburgh on 13 May 2025. Dave Turner has been invited to speak at a Hansa BioPharma event in November 2025 where approaches to transplanting highly HLA sensitised patients will be discussed.