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Desensitization strategies: is it worth it?

Sarat Kuppachi1, David A Axelrod2

  • 1Department of Internal Medicine, University of Iowa, Iowa City, IA, USA.

Transplant International : Official Journal of the European Society for Organ Transplantation
|September 26, 2019
PubMed

Preformed donor-specific antibodies (DSAs) limit access to transplantation for thousands of renal transplant patients. While kidney paired donation offers the best strategy for patients with a living donor, for very highly sensitized patients and those without living donors, a strategy of desensitization offers the best hope of transplantation. Removal of DSAs with plasmapheresis, intravenous immunoglobulin and anti-CD20 antibodies can permit successful transplantation. While the clinical outcomes remain inferior to compatible transplant and the costs are significantly greater, when compared with long-term dialysis treatment, these strategies are offer improved survival and are cost-effective given nationally accepted benchmarks.

Keywords:
desensitizationdonor-specific antibodyeconomic analysiskidney transplant

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