PMID- 17100695
OWN - NLM
STAT- MEDLINE
DCOM- 20070426
LR  - 20061114
IS  - 0902-0063 (Print)
IS  - 0902-0063 (Linking)
VI  - 20 Suppl 17
DP  - 2006
TI  - Desensitization strategies enabling successful renal transplantation in highly 
      sensitized patients.
PG  - 7-12
AB  - Currently, the number of highly sensitized patients awaiting a renal transplant 
      is increasing on the waiting lists of different organ exchange organizations. Due 
      to the presence of antibodies against a broad variety of human leukocyte antigen 
      (HLA) specificities, highly sensitized patients have a markedly reduced chance of 
      receiving a crossmatch-negative organ. It has long been recognized that 
      hyperacute rejection is associated with the presence of donor-specific anti-HLA 
      antibodies at the time of transplantation. Meanwhile treatment protocols have 
      been developed to achieve successful transplantation across antibody barriers. 
      Therefore, the presence of donor-specific anti-HLA antibodies and a positive 
      serological crossmatch are no longer considered as an absolute contraindication 
      to renal transplantation. Mainly, two desensitization protocols have been 
      established in order to overcome a positive crossmatch or to enhance the chance 
      of highly sensitized patients to receive a crossmatch-negative organ: high-dose 
      intravenous immunoglobulin (IVIg) or low-dose IVIg in combination with 
      plasmapheresis. Herein, we summarize the characteristics of these two treatment 
      regimes along with other alternative approaches that are currently used for the 
      management of kidney graft recipients with broad alloantibody reactivity against 
      potential kidney donors.
FAU - Beimler, J H M
AU  - Beimler JH
AD  - Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
FAU - Susal, C
AU  - Susal C
FAU - Zeier, M
AU  - Zeier M
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Denmark
TA  - Clin Transplant
JT  - Clinical transplantation
JID - 8710240
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Desensitization, Immunologic/*methods
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunoglobulins, Intravenous/administration & dosage
MH  - Kidney Transplantation/*immunology
RF  - 24
EDAT- 2006/11/15 09:00
MHDA- 2007/04/27 09:00
CRDT- 2006/11/15 09:00
PHST- 2006/11/15 09:00 [pubmed]
PHST- 2007/04/27 09:00 [medline]
PHST- 2006/11/15 09:00 [entrez]
AID - CTR594 [pii]
AID - 10.1111/j.1399-0012.2006.00594.x [doi]
PST - ppublish
SO  - Clin Transplant. 2006;20 Suppl 17:7-12. doi: 10.1111/j.1399-0012.2006.00594.x.