I play Ultima Online, and am in the process of creating a layout for the Kingdom Reborn client.
I also use AHK to simulate shift states, so I can have a matrix of spells to chose from using 2 keys (1 key only for the most used ones)
Here's the skin I have created for it so far...
01=up (left middle finger)
02=left (left ring finger)
03=right (left index finger)
04=down (left middle finger)
05=ctrl (run - side of left hand )
06=undefined (left pink)
07=target self (left pink)
08=undefined (left thumb)
09=undefined (left thumb)
10=undefined (left thumb)
11-18=matrix LINE keys (right hand as appropriate)
23-25=matrix ROW keys (state modifiers - right hand as appropriate)
11-18 + 23-25 work through AHK...