Desensitizing the Broadly Human Leukocyte Antigen-Sensitized Patient Awaiting Deceased Donor Kidney Transplantation

作者：Jordan S C^*; Reinsmoen N; Lai C H; Cao K; Kahwaji J; Peng A; Villicana R; Vo A

来源：Transplantation Proceedings, 2012, 44(1): 60-61.

DOI：10.1016/j.transproceed.2011.12.028

For broadly human leukocyte antigen sensitized patients (HS; calculated panel-reactive antibody >80%), options for deceased donor (DD) transplantation are extremely limited. Data from United Network for Organ Sharing (2000-2009) indicate that <10% of HS patients are transplanted each year. Immune modulation of HS patients using intravenous immunoglobulin (IVIG) and rituximab has shown promise in reducing donor-specific antibody (DSA) titers and improving the chances for successful transplantation for patients awaiting DD transplants. Critical to the success of desensitization with IVIG + rituximab is a coherent antibody-testing strategy aimed at detection of DSA reductions and identification of crossmatch parameters that are associated with a low likelihood of antibody-mediated rejection posttransplant. Here, we discuss data that examine the efficacy of IVIG + rituximab in reducing DSA levels and improving chances for a successful DD transplantation. Patient and graft survival data are also presented as is an analysis of the safety of IVIG + rituximab in sensitized patients.

• 出版日期2012-2