Desensitization Protocol Consisting of High-Dose Intravenous Immunoglobulin, Plasmapheresis, and Rituximab in Highly Sensitized Kidney Transplant Recipients
Nagoya Daini Red Cross Hospital, Nagoya, Japan
Meeting: 2022 American Transplant Congress
Abstract number: 1028
Keywords: Flowcytometry crossmatching, HLA antibodies, Immunoglobulins (Ig), Kidney transplantation
Topic: Clinical Science » Kidney » 36 - Kidney Immunosuppression: Desensitization
Session Information
Session Name: Kidney Immunosuppression: Desensitization
Session Type: Poster Abstract
Date: Sunday, June 5, 2022
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: In HLA incompatible kidney transplantation, donor-specific HLA antibody often causes antibody-mediated rejection (AMR). To prevent AMR, we adopted a preoperative desensitization protocol including high-dose intravenous immunoglobulin (IVIG), plasmapheresis (PEX) and rituximab in sensitized recipients with positive flow cytometry crossmatch (FCXM).
*Methods: Patients who received the desensitization therapy with IVIG, PEX and rituximab for HLA incompatible living donor kidney transplantation (LDKT) since 2014 were included. We retrospectively investigated the patient background, clinical courses, DSA levels, and graft function.
*Results: Among the 11 HLA incompatible LDKT, AMR was revealed in 2 cases (18.2%) within 1 month after transplantation. There was no grafts loss during an average of 2.6-year follow-up. Average graft function was acceptable, with a serum creatinine level of 1.3 ± 0.7 mg/dL.
*Conclusions: The desensitization protocol including high-dose IVIG, PEX and rituximab is effective for achieving successful transplant outcomes in HLA incompatible LDKT with positive FCXM, which can spare aggressive treatments, such as C5 inhibitors, proteasome inhibitors, or imlifidase.
To cite this abstract in AMA style:
Okada M, Hiramitsu T, Tomosugi T, Futamura K, Narumi S, Goto N, Watarai Y. Desensitization Protocol Consisting of High-Dose Intravenous Immunoglobulin, Plasmapheresis, and Rituximab in Highly Sensitized Kidney Transplant Recipients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/desensitization-protocol-consisting-of-high-dose-intravenous-immunoglobulin-plasmapheresis-and-rituximab-in-highly-sensitized-kidney-transplant-recipients/. Accessed May 25, 2025.« Back to 2022 American Transplant Congress