The highly sensitized patient. Therapeutic alternatives for kidney transplantation |
| |
Authors: | Mancilla-Urrea Eduardo |
| |
Institution: | Departamento de Nefrología del Instituto Nacional de Cardiología Ignacio Chávez, México, DF. emulmps@mexis.com |
| |
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-thymocyte 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. |
| |
Keywords: | |
本文献已被 PubMed 等数据库收录! |
|