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Plenary 2: Hyper Immune

Plenary 2: Hyper Immune 160 Desensitization in kidney transplantation at Cincinnati College of Medicine Steve Woodle 1 1 University of Cincinnati College of Medicine, Cincinnati, OH, United States Desensitization is a term used in transplantation for immunomodulating therapies designed to reduce HLA allosensitization prior to transplantation. Desensitization therapies have been employed for over two decades, and have almost exclusively been based on intravenous immune globulin (IVIG) therapy. Although a considerable experience has been gained to date with IVIG‐based therapies, the quality of the extant evidence based remains less than robust, and practical and strategic limitations remain to IVIG‐based approaches. Practical limitations include lack of efficacy in the most highly sensitized patients, cost, and failure to reduce HLA antibody levels when measured by solid phase assays. Strategically, IVIG does not eliminate the source of HLA antibody production, viz, the plasma cell. Over the past several years, plasma cell targeted therapies have been developed based on the proteasome inhibitor, bortezomib, and have been reduced to practice in sensitized transplant recipients. A large prospective, iterative trial has been conducted in highly sensitized kidney transplant candidates that examines the effects of plasmapheresis, rituximab, and bortezomib dosing density on short term on long term HLA antibody levels. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Xenotransplantation Wiley

Plenary 2: Hyper Immune

Xenotransplantation , Volume 20 (5) – Sep 1, 2013
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Publisher
Wiley
Copyright
© 2013 John Wiley & Sons A/S
ISSN
0908-665X
eISSN
1399-3089
DOI
10.1111/xen.12060_2
Publisher site
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Abstract

160 Desensitization in kidney transplantation at Cincinnati College of Medicine Steve Woodle 1 1 University of Cincinnati College of Medicine, Cincinnati, OH, United States Desensitization is a term used in transplantation for immunomodulating therapies designed to reduce HLA allosensitization prior to transplantation. Desensitization therapies have been employed for over two decades, and have almost exclusively been based on intravenous immune globulin (IVIG) therapy. Although a considerable experience has been gained to date with IVIG‐based therapies, the quality of the extant evidence based remains less than robust, and practical and strategic limitations remain to IVIG‐based approaches. Practical limitations include lack of efficacy in the most highly sensitized patients, cost, and failure to reduce HLA antibody levels when measured by solid phase assays. Strategically, IVIG does not eliminate the source of HLA antibody production, viz, the plasma cell. Over the past several years, plasma cell targeted therapies have been developed based on the proteasome inhibitor, bortezomib, and have been reduced to practice in sensitized transplant recipients. A large prospective, iterative trial has been conducted in highly sensitized kidney transplant candidates that examines the effects of plasmapheresis, rituximab, and bortezomib dosing density on short term on long term HLA antibody levels.

Journal

Xenotransplantation – Wiley

Published: Sep 1, 2013

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