*Purpose: With a goal to develop a safe, effective, and consistent approach to desensitization therapy using IVIg in lung transplant (LuT), we instituted a standard of care protocol for desensitization in patients awaiting a lung transplant with antibodies reactive to HLA antigens present in their serum.

*Methods: 36 patients received desensitization therapy consisting of IVIg at a weight based dose of 2 grams/kilogram per month (i.e. high dose IVIg). In addition, 5 patients also received concomitant rituximab therapy. Post-transplant follow-up laboratory, biopsy, and graft status data collection occurred as part of normal transplant care. Kaplan-Meier analysis was used to determine probability of survival. Survival was compared to non-sensitized LuT patient between 2013 and 2017.

*Results: Of the 36 LuT patients who received desensitization, 17 were transplanted achieving an effective transplant rate of 47%. Post LuT, 10 (59%) have experienced a rejection episode within the first post-transplant year. Five patients have experienced allograft failure (29%, Fig A). Survival at 1-, 3- and 5-years was 92%, 69%, and 52%, respectively. Compared to non-sensitized patient at the center between 2013 and 2017, graft survival rates between desensitized and non-sensitized patients were similar (Fig B).

*Conclusions: By using one protocol in a large number of LuT patients, we feel that we have strong evidence that we can achieve equivalent post-transplant results in those LuT patients who are sensitized (compared to unsensitized patients).

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