August 5, 2011

Desensitization in HLA-Incompatible Kidney Recipients and Survival

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For patients with high levels of anti-HLA antibodies, waiting times for a kidney transplant are significantly longer than average. Desensitization allows the barrier of a positive crossmatch to be overcome, but there are concerns related to the long-term risks of chronic antibody-mediated rejection. This paper reports an experienced centre’s results with a group of patients at various levels of risk: CDC-positive crossmatch, flow cytometry=positive crossmatch, or detection of donor-specific antibody. Outcomes were compared to two groups of matched controls, one who had remained on the transplant waiting list, and a second that was subsequently transplanted. Patient survival in the desensitization group was superior to the other two groups, even after more than five years of follow-up.

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