Frontiers of Medicine

, Volume 5, Issue 1, pp 80–85 | Cite as

Successful kidney transplantation in highly sensitized patients

  • Weijie Zhang
  • Dong Chen
  • Zhishui Chen
  • Fanjun Zeng
  • Changsheng Ming
  • Zhengbin Lin
  • Ping Zhou
  • Gang Chen
  • Xiaoping Chen
Research Article

Abstract

Highly sensitized patients experience an increased number of rejection episodes and have poorer graft survival rates; hence, sensitization is a significant barrier to both access to and the success of organ transplantation. This study reports our experience in kidney transplantation in highly sensitized patients. Fourteen patients with sensitization or high levels of panelreactive antibodies (PRA) were studied. All patients were desensitized with pre-transplant intravenous immunoglobulin (IVIG)/plasmapheresis (PP) with or without rituximab and thymoglobulin induction therapy, combined with a Prograf/MMF/Pred immunosuppressive regimen. Of 14 patients, 10 showed good graft functions without acute rejection (AR) episodes. Acute cellular rejection in two patients was reversed by methylprednisolone. Two patients underwent antibody-mediated rejection; one was treated with PP/IVIG successfully, whereas the other lost graft functions due to the de novo production of donor-specific antibodies (DSA). Graft functions were stable, and there were no AR episodes in other patients. Conclusively, desensitization using PP/IVIG with or without rituximab increases the likelihood of successful live-donor kidney transplantation in sensitized recipients.

Keywords

Kidney transplantation desensitization 

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Copyright information

© Higher Education Press and Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • Weijie Zhang
    • 1
  • Dong Chen
    • 1
  • Zhishui Chen
    • 1
  • Fanjun Zeng
    • 1
  • Changsheng Ming
    • 1
  • Zhengbin Lin
    • 1
  • Ping Zhou
    • 1
  • Gang Chen
    • 1
  • Xiaoping Chen
    • 1
  1. 1.Institute of Organ Transplantation, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science & Technology, Key Laboratory of Organ Transplantation, Ministry of Education and Ministry of HealthWuhanChina

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