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Related Experiment Videos

Presensitization: the problem and its management.

Stanley C Jordan1, Mark D Pescovitz

  • 1Transplant Immunology Laboratory, Cedars-Sinai Medical Center, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California 90048, USA. sjordan@cshs.org

Clinical Journal of the American Society of Nephrology : CJASN
|August 21, 2007
PubMed
Summary
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Novel therapies show promise for highly HLA-sensitized patients awaiting transplantation. Intravenous immunoglobulin (IVIg) and rituximab are effective in removing antibodies, but more controlled trials are needed.

Area of Science:

  • Immunology
  • Transplantation Science
  • Nephrology

Background:

  • Highly HLA-sensitized patients present significant challenges for successful organ transplantation due to pre-formed antibodies.
  • Conventional immunosuppression is often insufficient for these patients, necessitating novel desensitization strategies.

Purpose of the Study:

  • To review and evaluate emerging therapeutic approaches for antibody removal in highly HLA-sensitized patients.
  • To assess the efficacy and safety of various desensitization agents, including IVIg, rituximab, and others.

Main Methods:

  • Review of current literature on desensitization protocols for HLA-sensitized transplant candidates.
  • Analysis of clinical data regarding the effectiveness of agents like IVIg, rituximab, alemtuzumab, and protein A immunoabsorption.

Related Experiment Videos

  • Evaluation of B-cell targeting therapies and their impact on antibody-mediated rejection.

    • Main Results:

    • High-dose IVIg, alone or with plasmapheresis, demonstrates significant efficacy.
    • Rituximab shows safety and some efficacy but often requires combination therapy.
    • Alemtuzumab is less suitable due to failure in preventing antibody-mediated rejection.

    Conclusions:

    • Several novel agents, including IVIg and rituximab, offer potential for desensitization in highly HLA-sensitized patients.
    • Combination therapies may be necessary for optimal outcomes.
    • A critical need exists for well-controlled clinical trials to validate these approaches.