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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2005, Number 2

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Rev Invest Clin 2005; 57 (2)

Highly sensitized patient. Renal transplant therapeutic alternatives

Mancilla-Urrea E

Language: Spanish
References: 54
Page: 206-212
PDF size: 62.43 Kb.


ABSTRACT

Patients become sensitized after exposure to non-self human leukocyte antigen (HLA) during pregnancy, blood transfusion, and organ transplantation. Performing transplantation in highly sensitized receptors represents a challenge for transplant programs, organ allocation organizations and usually patients are forced to stay on transplant waiting lists for many years and ultimately may never find a donor. There are various approaches that can be adopted in order to transplant these patients such as plasmapheresis, immunoadsorption, intravenous immune globulin, anti-timocitic agents, monoclonal antibodies (anti CD-20) and splenectomy with similar results as obtained in non highly sensitized patients with the increased risk of severe and recurrent rejection which may carry implications for long-term graft outcomes. Thus a positive crossmatch test is not necessarily an absolute contraindication and allows access for transplantation.


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