Desensitization strategies: is it worth it?

Article: Desensitization strategies: is it worth it?

Authors: Sarat Kuppachi, David A. Axelrod

Journal: doi: 10.1111/TRI.13532


Preformed donor specific antibodies limit access to transplantation for thousands of renal transplant patients. While kidney paired donation offers the best strategy for patients with a living donor, for very highly sensitized patients and those without living donors, a strategy of desensitization offers the best hope of transplantation. Removal of donor specific antibodies with plasmapheresis, intravenous immunoglobulin, and anti‐CD20 antibodies can permit successful transplantation. While the clinical outcomes remain inferior to compatible transplant and the costs are significantly greater, when compared with long term dialysis treatment, these strategies are offer improved survival and are cost effective given nationally accepted benchmarks.

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