PMID- 34233438
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211008
IS  - 2211-9132 (Print)
IS  - 2211-9140 (Electronic)
IS  - 2211-9132 (Linking)
VI  - 40
IP  - 3
DP  - 2021 Sep
TI  - Kidney transplantation in highly sensitized recipients.
PG  - 355-370
LID - 10.23876/j.krcp.21.012 [doi]
AB  - In kidney transplantation (KT), overcoming donor shortage is particularly 
      challenging in patients with preexisting donor-specific antibodies (DSAs) against 
      human leukocyte antigen (HLA), called HLA-incompatible KT (HLAi KT), carrying the 
      risk of rejection and allograft loss. Thus, it is necessary to accurately 
      evaluate the degree of sensitization before HLAi KT, and undertake appropriate 
      pretreatment strategies. To determine the degree of sensitization, 
      complement-dependent cytotoxicity has been the only method employed; the 
      development of a method using flow cytometry further improved the test 
      sensitivity. However, these tests present disadvantages, including the need for 
      living cells, with a solid-phase assay developed to resolve this problem. 
      Currently, the method using Luminex (Luminex Corp.) is widely used in clinical 
      practice. As this method measures DSAs using single antigen beads, it is possible 
      to classify immunological risks by measuring the type and amount of DSAs. 
      Furthermore, there have been major advances in methods that involve DSA removal 
      before HLAi KT. In the early stages of desensitization, plasmapheresis and 
      intravenous immunoglobulins were the main treatment methods employed; however, 
      the introduction of CD20 monoclonal antibody and proteasome inhibitors further 
      increased the success rate of desensitization. Currently, HLAi KT has been 
      established as an important transplant method, but an understanding of DSAs and a 
      novel desensitization treatment are warranted.
FAU - Park, Yohan
AU  - Park Y
AD  - Division of Nephrology, Department of Internal Medicine and Transplantation 
      Research Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic 
      University of Korea, Seoul, Republic of Korea.
FAU - Ko, Eun Jeong
AU  - Ko EJ
AD  - Division of Nephrology, Department of Internal Medicine and Transplantation 
      Research Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic 
      University of Korea, Seoul, Republic of Korea.
FAU - Chung, Byung Ha
AU  - Chung BH
AD  - Division of Nephrology, Department of Internal Medicine and Transplantation 
      Research Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic 
      University of Korea, Seoul, Republic of Korea.
FAU - Yang, Chul Woo
AU  - Yang CW
AD  - Division of Nephrology, Department of Internal Medicine and Transplantation 
      Research Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic 
      University of Korea, Seoul, Republic of Korea.
LA  - eng
PT  - Journal Article
DEP - 20210625
PL  - Korea (South)
TA  - Kidney Res Clin Pract
JT  - Kidney research and clinical practice
JID - 101586778
PMC - PMC8476304
OTO - NOTNLM
OT  - Alloantibodies
OT  - Bortezomib
OT  - HLA antigens
OT  - Kidney transplantation
OT  - Plasmapheresis
OT  - Rituximab
COIS- Conflict of interest All authors have no conflicts of interest to declare.
EDAT- 2021/07/09 06:00
MHDA- 2021/07/09 06:01
PMCR- 2021/09/01
CRDT- 2021/07/08 03:24
PHST- 2021/01/09 00:00 [received]
PHST- 2021/03/02 00:00 [accepted]
PHST- 2021/07/09 06:00 [pubmed]
PHST- 2021/07/09 06:01 [medline]
PHST- 2021/07/08 03:24 [entrez]
PHST- 2021/09/01 00:00 [pmc-release]
AID - j.krcp.21.012 [pii]
AID - j-krcp-21-012 [pii]
AID - 10.23876/j.krcp.21.012 [doi]
PST - ppublish
SO  - Kidney Res Clin Pract. 2021 Sep;40(3):355-370. doi: 10.23876/j.krcp.21.012. Epub 
      2021 Jun 25.