Transplanting the highly sensitized patient: Trials and tribulations

Current Opinion in Nephrology and Hypertension

Volumn 22, Issue 6, 2013, Pages 681-688

  Iyer, Hariharan S ^a   Jackson, Annette M ^b   Zachary, Andrea A ^b   Montgomery, Robert A ^c  

^a UNIVERSITY OF WESTERN ONTARIO   (Canada)

^b Department of Medicine ^*  (United States)

^c DEPARTMENT OF PATHOLOGY   (United States)

Author keywords

complement inhibition; desensitization; donor specific antibodies; kidney paired donation

Indexed keywords

ALEMTUZUMAB; B CELL ACTIVATING FACTOR; BELIMUMAB; BORTEZOMIB; COMPLEMENT COMPONENT C1Q; COMPLEMENT COMPONENT C1S INHIBITOR; COMPLEMENT INHIBITOR; ECULIZUMAB; HLA ANTIBODY; HLA ANTIGEN; IMMUNOGLOBULIN G; INTERLEUKIN 2 RECEPTOR ALPHA; INTERLEUKIN 6; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; RITUXIMAB; TACROLIMUS; TECLOTHIAZIDE; THYMOCYTE ANTIBODY; TOCILIZUMAB;

ANTIBODY MEDIATED REJECTION; CELL ACTIVATION; CELL DIFFERENTIATION; COMPLEMENT ACTIVATION; DESENSITIZATION; DRUG MEGADOSE; GRAFT RECIPIENT; GRAFT SURVIVAL; HEMOLYTIC UREMIC SYNDROME; HLA SYSTEM; HUMAN; IMMUNOADSORPTION; IMMUNOASSAY; IMMUNOGENETICS; KIDNEY GRAFT; KIDNEY GRAFT REJECTION; KIDNEY TRANSPLANTATION; LOW DRUG DOSE; MULTICENTER STUDY (TOPIC); ORGAN DONOR; PHASE 2 CLINICAL TRIAL (TOPIC); PLASMAPHERESIS; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW;

ABO BLOOD-GROUP SYSTEM; DESENSITIZATION, IMMUNOLOGIC; GRAFT REJECTION; HISTOCOMPATIBILITY TESTING; HLA ANTIGENS; HUMANS; IMMUNITY, HUMORAL; ISOANTIBODIES; KIDNEY TRANSPLANTATION; TISSUE AND ORGAN PROCUREMENT; TISSUE DONORS; TRANSPLANTATION IMMUNOLOGY;

EID: 84887014893     PISSN: 10624821     EISSN: 14736543     Source Type: Journal    
DOI: 10.1097/MNH.0b013e328365b3b9     Document Type: Review

References (40)

1. OPTN/SRTR annual report 2011. http://optn.transplant.hrsa.gov. [Accessed 1 June 201]
2. Zachary A, Montgomery RA, Leffell M. Defining unacceptable HLA antigens. Curr Opin Organ Transplant 2008; 13:405-410.
3. Cecka JM. Calculated PRA (CPRA): the new measure of sensitization for transplant candidates. Am J Transplant 2009; 10:26-29.
4. Eng SE, Leffell M. Histocompatibility testing after fifty years of transplantation. J Immunol Methods 2011; 369:1-21.
5. Leffell M. The calculated panel reactive antibody policy: an advancement improving organ allocation. Curr Opin Organ Transplant 2011; 16:404-409.
6. Chang D, Kobashigawa J. The use of calculated panel-reactive antibody and virtual cross match in heart transplantation. Curr Opin Organ Transplant 2012; 17:423-426.
7. Claas FH, Rahmel A, Doxiadis II. Enhanced kidney allocation to highly sensitized patients by the acceptable mismatch program. Transplantation 2009; 88:447-452.
8. Morath C, Opelz G, Zeier M, Susal C. Recent developments in desensitization of crossmatch-positive kidney transplant recipients. Transplant Proc 2012; 44:1648-1651.
9. Montgomery RA. Renal transplantation across HLA and ABO antibody barriers: Integrating paired donation into desensitization protocols. Am J Transplant 2010; 10:449-457.
10. Montgomery RA, Warren D, Segev D, Zachary A. HLA incompatible renal transplantation. Curr Opin Organ Transplant 2012; 17:386-392.
11. Haririan A, Nogueira J, Kukuruga D, et al. Positive cross-match living donor kidney transplantation: longer-term outcomes. Am J Transplant 2009; 9:536-542.
12. Higgins R, Lowe D, Hathaway M. Human leukocyte antigen antibody incompatible renal transplantation: excellent medium-term outcomes with negative cytotoxic crossmatch. Transplantation 2011; 92:900-906.
13. Montgomery RA, Lonze BE, King KE, et al. Desensitization in HLAincompatible kidney recipients and survival. N Engl J Med 2011; 365: 318-326.
14. Jordan SC, Tyan D, Stablein D, et al. Evaluation of intravenous immunoglobulin as an agent to lower allosensitization and improve transplantation in highly sensitized adult patients with end-stage renal disease: report of the NIHIG02 trial. J Am Soc Nephrol 2004; 15:3256-3262.
15. Vo AA, Lukovsky M, Toyoda M, et al. Rituximab and intravenous immunoglobulin for desensitization during renal transplantation. N Engl J Med 2008; 359:242-251.
16. Kahwaji J, Sinha A, Toyoda M, et al. Infectious complications in kidney transplant recipients receiving rituximab with IVIG for desensitization. Clin J Am Soc Nephrol 2011; 6:2894-2900.
17. Alachkar N, Lonze BE, Zachary AA, et al. Infusion of high-dose intravenous immunoglobulin fails to lower the strength of human leukocyte antigen antibodies in highly sensitized patients. Transplantation 2012; 94:165-171.
18. Rees MA, Kopke JE, Pelletier RP. A nonsimultaneous, extended, altruisticdonor chain. N Engl J Med 2009; 360:1096-1101.
19. Gentry SE, Montgomery RA, Segev DL. Kidney paired donation: fundamentals, limitations, and expansions. Am J Kidney Dis 2011; 57:144-151.
20. Segev DL, Gentry SE, Warren DS, et al. Kidney paired donation and optimizing the use of live donor organs. JAMA 2005; 293:1883-1890.
21. Chkhotua A. Paired kidney donation: outcomes, limitations and future perspectives. Transplant Proc 2012; 44:1790-1792.
22. Montgomery RA, Zachary AA, Ratner LE, et al. Clinical results from transplanting incompatible live kidney donor/recipient pairs using kidney paired donation. JAMA 2005; 294:1655-1663.
23. Jackson A, Leffell M, Montgomery R, et al. A GPS for finding the route to transplantation for the sensitized patient. Curr Opin Organ Transplant 2012; 17:433-439.
24. Zachary AA, Kopchaliiska D, Montgomery RA. HLA-specific B cells: II. Application to transplantation. Transplantation 2007; 83:989-994.
25. Zachary A, Lucas D, Montgomery R, et al. Rituximab prevents an anamnestic response in patients with cryptic sensitization. Transplantation 2013; 95:701-704.
26. Chen G, Sequeira F, Tyan DB. Novel C1q assay reveals a clinically relevant subset of human leukocyte antigen antibodies independent of immunoglobulin G strength on single antigen beads. Hum Immunol 2011; 72: 849-858.
27. Schnaidt M, Weinstock C, Jurisic M, et al. HLA antibody specification using single-antigen beads: a technical solution for the prozone effect. Transplantation 2011; 92:510-515.
28. Jackson AM, Kuperman MB, Montgomery RA. Multiple hyperacute rejections in the absence of detectable complement activation in a patient with endothelial cell reactive antibody. Am J Transplant 2012; 12:1643-1649.
29. Breimer ME, Rydberg L, Jackson AM, et al. Multicenter evaluation of a novel endothelial cell crossmatch test in kidney transplantation. Transplantation 2009; 87:549-556.
30. Jackson AM, Lucas DP, Melancon JK, et al. Clinical relevance and IgG subclass determination of non-HLA antibodies identified using endothelial cell precursors isolated from donor blood. Transplantation 2011; 92:54-60.
31. Alachkar N, Gupta G, Montgomery RA. Angiotensin antibodies and focal segmental glomerulosclerosis. N Engl J Med 2013; 368:971-973.
32. Dragun D, Muller DN, Brasen JH, et al. Angiotensin II type 1-receptor activating antibodies in renal-allograft rejection. N Engl J Med 2005; 352:558-569.
33. Stegall MD, Diwan T, Raghavaiah S, et al. Terminal complement inhibition decreases antibody-mediated rejection in sensitized renal transplant recipients. Am J Transplant 2011; 11:2405-2413.
34. Kaplan B, Gangemi A, Thielke J, et al. Successful rescue of refractory, severe antibody mediated rejection with splenectomy. Transplantation 2007; 83:99-100.
35. Locke JE, Zachary AA, Haas M, et al. The utility of splenectomy as rescue treatment for severe acute antibody mediated rejection. Am J Transplant 2007; 7:842-846.
36. Woodle ES, Morrow W, Frazier E. Rapid reduction in donor-specific antihuman leukocyte antigen antibodies and reversal of antibody-medicated rejection with bortezomib in pediatric heart transplant patients. Transplantation 2012; 93:319-324.
37. Stegall M, Diwan T, Raghavaiah S, Burns J. The impact of proteasome inhibition on alloantibody-producing plasma cells in vivo. Transplantation 2011; 91:536-541.
38. Mengel M, Sis B, Haas M. Banff 2011 meeting report: new concepts in antibody-mediated rejection. Am J Transplant 2012; 12:563-570.
39. Sellares J, Reeve J, Loupy A, et al. Molecular diagnosis of antibody-mediated rejection in human kidney transplants. Am J Transplant 2013; 13:971-983.
40. Sinha D, Lambie M, Krishnan N. Cryofiltration in the treatment of cryoglobulinemia and HLA antibody-incompatible transplantation. Ther Apher Dial 2012; 16:91-96.