Salvadori, M. Update on Desensitization Strategies and Drugs on Hyperimmune Patients for Kidney Transplantation. Transplantology2023, 4, 139-150.
Salvadori, M. Update on Desensitization Strategies and Drugs on Hyperimmune Patients for Kidney Transplantation. Transplantology 2023, 4, 139-150.
Salvadori, M. Update on Desensitization Strategies and Drugs on Hyperimmune Patients for Kidney Transplantation. Transplantology2023, 4, 139-150.
Salvadori, M. Update on Desensitization Strategies and Drugs on Hyperimmune Patients for Kidney Transplantation. Transplantology 2023, 4, 139-150.
Abstract
Abstract: Presence in a recipient of antibodies directed against donor specific antigens represent a major obstacle in transplanting such patients. Removal of these antibodies represents a challenge for physicians dealing with kidney transplantation. Several strategies, techniques and old and new drugs are to date used to desensitize these patients.
Desensitization may occur before transplantation or at the time of transplantation or after transplantation according whether physicians deal with living or deceased donors. Different techniques may be used to reveal the presence of antibodies in the recipients; each technique has different sensitivity and specificity, different advantages and disadvantages.
The target of the drugs used to desensitize are B cells, Plasma cells, the antibodies themselves and finally, the complement that is the final actor causing tissue disruption.
If B cells are relatively easy to be targeted, more difficult are the plasma cell. Indeed, several new drugs are used in randomized trials also to defeat plasma cells. Antibodies may be removed rather easily, but often their removal is followed by a rebound.
Complement is not easy to be defeated and new drugs are to date used to be successful in this action. However is to date possible to desensitize many patients and to obtain successful transplantation.
Keywords
Desensitization; Donor specific antibodies; HLA system; antibodies identification; B cells; Plasma cells; Complement; New drugs; Desensitization; Donor specific antibodies; HLA system; B cells; Plasma cells; Complemennt; New drugs
Subject
Medicine and Pharmacology, Transplantation
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
