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Transplantation

Desensitization and survival in kidney transplant recipients

Nature Reviews Nephrology volume 13, pages 196–198 (2017)Cite this article

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Elimination of donor-specific antibodies against HLA has been used to enable transplantation of HLA-incompatible kidneys from living donors. In contrast to two previous US studies, a UK study now reports that desensitization does not offer a survival benefit over remaining on the waitlist for a compatible organ.

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References

  1. Opelz, G. President's address. The Transplantation Society — Berlin 2012. Transplantation 95, 4–7 (2013).

    Article  Google Scholar 

  2. Manook, M. et al. Post-listing survival for highly sensitised patients on the UK kidney transplant waiting list: a matched cohort analysis. Lancet http://dx.doi.org/10.1016/S0140-6736(16)31595-1 (2017).

  3. Süsal, C. et al. Determination of unacceptable HLA antigen mismatches in kidney transplant recipients: recommendations of the German Society for Immunogenetics. Tissue Antigens 86, 317–323 (2015).

    Article  Google Scholar 

  4. Süsal, C. & Morath, C. Current approaches to the management of highly sensitized kidney transplant patients. Tissue Antigens 77, 177–186 (2011).

    Article  Google Scholar 

  5. Montgomery, R. A. et al. Desensitization in HLA-incompatible kidney recipients and survival. N. Engl. J. Med. 365, 318–326 (2011).

    Article  CAS  Google Scholar 

  6. Orandi, B. J. et al. Survival benefit with kidney transplants from HLA-incompatible live donors. N. Engl. J. Med. 374, 940–950 (2016).

    Article  CAS  Google Scholar 

  7. Bentall, A. et al. Five-year outcomes in living donor kidney transplants with a positive crossmatch. Am. J. Transplant. 13, 76–85 (2013).

    Article  CAS  Google Scholar 

  8. Gondos, A., Döhler, B., Brenner, H. & Opelz, G. Kidney graft survival in Europe and the United States: strikingly different long-term outcomes. Transplantation 95, 267–274 (2013).

    Article  Google Scholar 

  9. Süsal, C. et al. Donor-specific antibodies require preactivated immune system to harm renal transplant. EBioMedicine 9, 366–371 (2016).

    Article  Google Scholar 

  10. Opelz, G. et al. Three-year outcomes following 1420 ABO-incompatible living-donor kidney transplants performed after ABO antibody reduction: results from 101 centers. Transplantation 99, 400–404 (2015).

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We would like to thank Dr Undine Samuel from the Eurotransplant Foundation, Leiden, Netherlands and Dr Abdullah Sakarcan from Reading, Pennsylvania, USA, for useful information on sensitized patients in the Eurotransplant region and the USA.

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Authors and Affiliations

  1. Caner Süsal and Gerhard Opelz are at the Institute of Immunology, Transplantation Immunology, University of Heidelberg, Im Neuenheimer Feld 305, Heidelberg, D-69120, Germany

    Caner Süsal & Gerhard Opelz

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  1. Caner Süsal
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  2. Gerhard Opelz
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Correspondence to Caner Süsal.

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Competing interests

C.S. has received lecture fees from Fresenius and Miltenyi, who produce immunoadsorption devices for desensitization. G.O. declares no competing interests.

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Süsal, C., Opelz, G. Desensitization and survival in kidney transplant recipients. Nat Rev Nephrol 13, 196–198 (2017). https://doi.org/10.1038/nrneph.2017.24

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