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Review
. 2023 Feb 1;107(2):351-360.
doi: 10.1097/TP.0000000000004279. Epub 2022 Aug 5.

Desensitization in Crossmatch-positive Kidney Transplant Candidates

Johan Noble  1   2 , Thomas Jouve  1   2 , Paolo Malvezzi  1 , Lionel Rostaing  1   2   3
Affiliations
Review

Desensitization in Crossmatch-positive Kidney Transplant Candidates

Johan Noble et al. Transplantation. .

Abstract

Access to kidney transplantation is limited by HLA-specific sensitization. Desensitization strategies enable crossmatch-positive kidney transplantation. In this review, we describe clinical experience gained over the last 20 y using desensitization strategies before kidney transplantation and describe the different tools used (both drugs and apheresis options), including IVIg, rituximab, apheresis techniques, interleukin-6 interference, proteasome inhibition, enzymatic degradation of HLA antibodies, complement inhibition, and B cytokine interference. Although access to transplantation for highly sensitized kidney transplantation candidates has been vastly improved by desensitization strategies, it remains, however, limited by the recurrence of HLA antibodies after transplantation and the occurrence of antibody-mediated rejection.

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Conflict of interest statement

L.R. has received honoraria from BMS and Hansa Bopharma. The other authors declare no conflicts of interest.

References

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