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Related Experiment Videos

The hyperimmunized patient: from sensitization toward transplantation.

F H Claas1, J J van Rood

  • 1Department of Immunohematology and Blood Bank, University Hospital Leiden, The Netherlands.

Transplant International : Official Journal of the European Society for Organ Transplantation
|July 1, 1988
PubMed
Summary

Highly sensitized patients face long waits for kidney transplants. A strategy using "acceptable mismatches" (HLA-A and -B antigens a patient hasn't formed antibodies against) improves donor selection.

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Transplantation·2001

Area of Science:

  • Nephrology
  • Immunology
  • Transplantation

Background:

  • Highly sensitized patients often remain on renal transplant waiting lists due to difficulties finding compatible donors.
  • High levels of sensitization lead to positive crossmatches with most potential organ donors, complicating transplantation.

Purpose of the Study:

  • To discuss the origins of patient sensitization in the context of organ transplantation.
  • To review strategies for identifying crossmatch-negative donors for hyperimmunized recipients.
  • To emphasize a specific local strategy for selecting kidney donors based on acceptable mismatches.

Main Methods:

  • Review of sensitization origins and donor selection efforts for hyperimmunized patients.
  • Detailed examination of a local strategy focusing on Human Leukocyte Antigen (HLA)-A and -B mismatches.

Related Experiment Videos

  • Implementation of kidney donor selection based on patient HLA compatibility and acceptable HLA-A and -B antigens.

    • Main Results:

    • Identified "acceptable mismatches" (HLA-A and -B antigens lacking patient alloantibodies) as key to donor selection.
    • Demonstrated that donor selection can be based on compatibility with the patient's HLA antigens plus acceptable HLA-A and -B antigens.
    • Showcased the operational feasibility of this strategy through a central organ-sharing office.

    Conclusions:

    • The "acceptable mismatches" strategy offers a viable approach to improve donor selection for hyperimmunized renal transplant candidates.
    • This method enhances the chances of successful transplantation by utilizing specific HLA compatibility criteria.
    • Centralized operation of this strategy can streamline the organ allocation process for complex cases.