HLA epitopes on the donor HLA are important in the success of solid organ transplantation. However, these epitopes can only be defined using high resolution typing results which are often not available prior to deceased donor allocation. The ability to perform high resolution at all HLA loci for deceased organ donor allocation prior to transplantation would have major clinical benefits, in particular for highly sensitised recipients. In May 2020, an in-house rapid high resolution third generation sequencing (TGS) HLA typing (ONT-Rapid HR, De Santis et al, 2020) method was implemented for on-call deceased donor HLA typing during the organ allocation process. HLA allele assignment is restricted to exon only providing 2-field typing resolution and better than previous low resolution SSO typing. The rapid ONT-Rapid HR method is able to obtain typing results at all HLA loci in approximately 4-4.5 hours while not prolonging the organ allocation process. A retrospective analysis to determine the benefits of the implementation of the ONT-Rapid HR method was performed. The frequency of changes to organ allocation lists was determined by reviewing and comparing on-call organ allocation lists generated using serological equivalent low-resolution typing and high resolution 2-field typing results. Of 25 cases reviewed that proceeded to renal transplant, TGS typing resulted in changes to 13 (52.0%) organ allocation lists, with up to 5 new recipient names appearing, including alterations to rank one in 4 cases. Renal transplant was offered to a different recipient in 4 cases, and accepted in 1 case, however this was not a highly sensitised patient. A review of cases involving highly sensitised patients, showed in a number of cases, these patients would have not been ranked on organ allocation lists and/or offered kidneys had it not been for the ability to report the HLA typing of the deceased donor to 2-field typing resolution, and therefore exclude unacceptable antigens (UAs) during organ allocation. In the case of a 33-year old highly sensitised (99.5% mPRA) male, previously transplanted overseas, on the waiting list for 13 years and only ranking once during that time (rank 6) on an allocation list, the HLA typing of a deceased donor using the ONT-HR method resulted in this patient being offered a kidney despite his high mPRA. The deceased donor was HLA typed as HLA-A*02:07, the patient had HLA-A*02:01, HLA-A*02:03 and HLA-A*02:06 listed as UAs and therefore any donor results entered as HLA-A*02 would have excluded this patient from an offer. Although HLA-A*02:07 was shown to share epitopes with the UAs in the patient, Cd3 antibody testing of the current serum showed weak HLA-A*02 reactivity, and the CDC T and B cell crossmatch was negative. The flow T and B cell crossmatch however was shown to be positive (peak and current). Surrogate CDC crossmatches against an HLA-A*02:07 mismatched donor was negative further confirming the risk was low for this patient. The implementation of the high-resolution typing method has simplified the donor specific antibody assessment process and provided opportunities to patients who previously were excluded from transplant.