PMID- 33565460
OWN - NLM
STAT- MEDLINE
DCOM- 20211027
LR  - 20211027
IS  - 1319-2442 (Print)
IS  - 1319-2442 (Linking)
VI  - 31
IP  - 6
DP  - 2020 Nov-Dec
TI  - Successful desensitization and kidney transplantation in the presence of 
      donor-specific anti-human leukocyte antigen antibodies in kidney transplant 
      recipients.
PG  - 1432-1438
LID - 10.4103/1319-2442.308365 [doi]
AB  - Kidney transplantation has indisputably revamped renal medicine and restored hope 
      among patients coming across fatal end-stage renal disease. However, 
      sensitization of human leukocyte antigen (HLA) triggers extensive immunological 
      fences to successful kidney transplantation and henceforth, transplant candidates 
      are frequently demoted to the ever-growing waiting list owing to preformed donor 
      specific antibodies (DSAs). Over the past few years, the advent of 
      desensitization protocols has significantly overpowered the immunological 
      barriers and enhanced the outcomes of kidney transplant recipients with DSAs 
      against HLA. Those desensitization protocols include combination of 
      plasmapheresis, high-dose intravenous immunoglobulin (IVIG), low-dose IVIG, 
      rituximab, and/or bortezomib. These immunomodulatory treatments either eliminate 
      DSAs or prevent their production. Lately, our transplant center developed and 
      used a desensitization protocol (Two sessions of plasmapheresis on day 1 and 2 --> 
      injection rituximab on day 2 after plasmapheresis -->no plasmapheresis on day 3 --> 
      eight sessions of plasmapheresis after day 3 and IVIG 100 mg/Kg/dose after each 
      session of plasmapheresis --> repeat HLA antibody detection test to confirm if DSAs 
      are present against HLA with median fluorescence intensity (MFI)values <1000 and 
      complement dependent cytotoxicity (CDC) crossmatch is negative for both T and B 
      lymphocytes; if NO then continue plasmapheresis sessions with IVIG 100 mg/kg/dose 
      till MFI values are <1000 and CDC crossmatch is negative for both T and B 
      lymphocytes or if YES then proceed for transplantation --> repeat dose of rituximab 
      post-transplantation) to evaluate its effectiveness in improving kidney function 
      in patients post-desensitization and kidney transplantation.
FAU - Khan, Muhammad Tassaduq
AU  - Khan MT
AD  - Renal Transplant Unit, National Institute of Solid Organ and Tissue 
      Transplantation, Dow University Hospital, Karachi, Pakistan.
FAU - Hamid, Rashid Bin
AU  - Hamid RB
AD  - Renal Transplant Unit, National Institute of Solid Organ and Tissue 
      Transplantation, Dow University Hospital, Karachi, Pakistan.
FAU - Sarfaraz, Sabahat
AU  - Sarfaraz S
AD  - Renal Transplant Unit, National Institute of Solid Organ and Tissue 
      Transplantation, Dow University Hospital, Karachi, Pakistan.
FAU - Lal, Naranjan
AU  - Lal N
AD  - Renal Transplant Unit, National Institute of Solid Organ and Tissue 
      Transplantation, Dow University Hospital, Karachi, Pakistan.
FAU - Ahmed, Jaleel
AU  - Ahmed J
AD  - Renal Transplant Unit, National Institute of Solid Organ and Tissue 
      Transplantation, Dow University Hospital, Karachi, Pakistan.
FAU - Luxmi, Shobha
AU  - Luxmi S
AD  - Renal Transplant Unit, National Institute of Solid Organ and Tissue 
      Transplantation, Dow University Hospital, Karachi, Pakistan.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - Saudi Arabia
TA  - Saudi J Kidney Dis Transpl
JT  - Saudi journal of kidney diseases and transplantation : an official publication of 
      the Saudi Center for Organ Transplantation, Saudi Arabia
JID - 9436968
RN  - 0 (Antibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunologic Factors)
RN  - 4F4X42SYQ6 (Rituximab)
SB  - IM
MH  - Adult
MH  - Allografts/immunology
MH  - Antibodies/*blood
MH  - B-Lymphocytes/immunology
MH  - Desensitization, Immunologic/*methods
MH  - Female
MH  - Graft Rejection/immunology/*prevention & control
MH  - HLA Antigens/*immunology
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - Immunologic Factors/therapeutic use
MH  - Kidney Failure, Chronic/surgery
MH  - Kidney Transplantation/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Plasmapheresis
MH  - Rituximab/therapeutic use
MH  - T-Lymphocytes/immunology
MH  - Young Adult
EDAT- 2021/02/11 06:00
MHDA- 2021/10/28 06:00
CRDT- 2021/02/10 08:38
PHST- 2021/02/10 08:38 [entrez]
PHST- 2021/02/11 06:00 [pubmed]
PHST- 2021/10/28 06:00 [medline]
AID - SaudiJKidneyDisTranspl_2020_31_6_1432_308365 [pii]
AID - 10.4103/1319-2442.308365 [doi]
PST - ppublish
SO  - Saudi J Kidney Dis Transpl. 2020 Nov-Dec;31(6):1432-1438. doi: 
      10.4103/1319-2442.308365.