J Korean Soc Transplant.  2008 Jun;22(1):8-12.

Renal Transplantation in Highly Sensitized Recipients

Affiliations
  • 1Transplantation Center, Kangnam St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. yangch@catholic.ac.kr

Abstract

Sensitized patients have a reduced chance of receiving a crossmath-negative organ, because of the presence of antibodies against a variety of human leukocyte antigen (HLA). There have been much attention and understanding on renal transplantation in sensitized patients, which led to attempts to remove alloantibodies and successful transplantation. Therefore, a positive crossmatch test and the presence of donor-specific anti-HLA antibodies are no longer a contraindication to renal transplantation. These desensitization protocols include intravenous immunoglobulin (IVIG), plasmapheresis (PP), and rituximab. IVIG therapy is performed in two forms, high dose IVIG and low dose IVIG in combination with PP. Rituximab is usually utilized in combination with IVIG therapy. Here we summarized the characterisitics of these strategies.

Keyword

Desenstization; Intravenous immunoglobulin; Plasmapheresis; Rituximab; Renal transplantation
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