Are sensitized patients better off with a desensitization transplant or waiting on dialysis?

Sensitization to human leukocyte antigens (HLAs) remains one of the major clinical challenges for successful kidney transplantation. Two large observational studies have recently addressed the question of whether individuals are better off with a desensitization treatment followed by HLA-incompatible living donor transplantation or waiting on the deceased donor kidney transplant list for a compatible transplant. The conflicting results of these 2 studies largely reflect differences in the study design and study population, leaving clinicians to make decisions about desensitization based largely on local expertise and anticipated waiting times for a compatible deceased donor transplant.