PMID- 26167458
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20150713
LR  - 20200930
IS  - 2220-6124 (Print)
IS  - 2220-6124 (Electronic)
IS  - 2220-6124 (Linking)
VI  - 4
IP  - 3
DP  - 2015 Jul 6
TI  - Modern approaches to incompatible kidney transplantation.
PG  - 354-62
LID - 10.5527/wjn.v4.i3.354 [doi]
AB  - The presence of human-leukocyte antigen (HLA)-antibodies and blood group 
      incompatibility remain a large barrier to kidney transplantation leading to 
      increased morbidity and mortality on the transplant waiting list. Over the last 
      decade a number of new approaches were developed to overcome these barriers. 
      Intravenous immunoglobulin (IVIG) remains the backbone of HLA desensitization 
      therapy and has been shown in a prospective, randomized, placebo controlled trial 
      to improve transplantation rates. Excellent outcomes with the addition of 
      rituximab (anti-B cell) to IVIG based desensitization have been achieved. There 
      is limited experience with bortezomib (anti-plasma cell) and eculizumab 
      (complement inhibition) for desensitization. However, these agents may be good 
      adjuncts for patients who are broadly sensitized with strong, complement-fixing 
      HLA antibodies. Excellent short and long-term outcomes have been achieved in ABO 
      incompatible transplantation with the combination of antibody removal, B cell 
      depletion, and pre-transplant immunosuppression. Kidney paired donation has 
      emerged as a reasonable alternative for programs who cannot provide 
      desensitization or in conjunction with desensitization. Future therapies directed 
      toward cytokines that alter B cell proliferation are under investigation.
FAU - Wongsaroj, Patarapha
AU  - Wongsaroj P
AD  - Patarapha Wongsaroj, Joseph Kahwaji, Ashley Vo, Stanley C Jordan, Cedars-Sinai 
      Medical Center, Comprehensive Transplant Center, Los Angeles, CA 90048, United 
      States.
FAU - Kahwaji, Joseph
AU  - Kahwaji J
AD  - Patarapha Wongsaroj, Joseph Kahwaji, Ashley Vo, Stanley C Jordan, Cedars-Sinai 
      Medical Center, Comprehensive Transplant Center, Los Angeles, CA 90048, United 
      States.
FAU - Vo, Ashley
AU  - Vo A
AD  - Patarapha Wongsaroj, Joseph Kahwaji, Ashley Vo, Stanley C Jordan, Cedars-Sinai 
      Medical Center, Comprehensive Transplant Center, Los Angeles, CA 90048, United 
      States.
FAU - Jordan, Stanley C
AU  - Jordan SC
AD  - Patarapha Wongsaroj, Joseph Kahwaji, Ashley Vo, Stanley C Jordan, Cedars-Sinai 
      Medical Center, Comprehensive Transplant Center, Los Angeles, CA 90048, United 
      States.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - World J Nephrol
JT  - World journal of nephrology
JID - 101610229
PMC - PMC4491925
OTO - NOTNLM
OT  - ABO incompatible
OT  - Antibodies
OT  - Bortezomib
OT  - Desensitization
OT  - Eculizumab
OT  - Intravenous immunoglobulin
OT  - Rituximab
EDAT- 2015/07/15 06:00
MHDA- 2015/07/15 06:01
PMCR- 2015/07/06
CRDT- 2015/07/14 06:00
PHST- 2014/10/20 00:00 [received]
PHST- 2015/03/11 00:00 [revised]
PHST- 2015/04/01 00:00 [accepted]
PHST- 2015/07/14 06:00 [entrez]
PHST- 2015/07/15 06:00 [pubmed]
PHST- 2015/07/15 06:01 [medline]
PHST- 2015/07/06 00:00 [pmc-release]
AID - 10.5527/wjn.v4.i3.354 [doi]
PST - ppublish
SO  - World J Nephrol. 2015 Jul 6;4(3):354-62. doi: 10.5527/wjn.v4.i3.354.