New Approaches For Desensitization Strategies Prior to Kidney Transplantation

摘要

Kidney transplantation is the treatment of choice for patients with chronic kidney failure. Not only does kidney transplantation prolong survival, but it also improves overall quality of life. Unfortunately, due to the shortage of kidney donors in the United States, the waiting time for a deceased donor kidney has increased to several years (up to 7 years in some parts of the country). To complicate matters further, for many patients, sensitization to human leukocyte antigens (HLAs) severely restricts the donor pool. One approach is donor exchange programs, where an ABO- or crossmatch-posi-tive incompatible donor donates to another recipient so that his or her intended recipient potentially receives a kidney from another living donor (ie, paired donation) or the deceased donor pool (ie, list donation). Unfortunately, many patients do not have any potential donors and are reliant on receiving a deceased donor kidney. Desensitization protocols that allow highly sensitized patients to receive a deceased donor kidney could fill this gap