a Department of Immunohematology and Blood Transfusion , Leiden University Medical Center , Leiden , the Netherlands.
Expert Rev Clin Immunol. 2018 Aug;14(8):673-679. doi: 10.1080/1744666X.2018.1498335. Epub 2018 Jul 13.
Highly sensitized patients awaiting a kidney transplant accrue on the transplant waiting list. The breadth of HLA antibodies in this subpopulation of patients precludes receiving a compatible organ offer through regular allocation within an acceptable time-frame. Areas covered: Several alternative options to receive a transplant exist for these patients, including additional priority in regular allocation, special programs based on allocation through acceptable antigens, kidney paired donation programs, desensitization protocols, or a combination of the latter two. In this review, these options and their outcomes are discussed as well as some possibilities to further enhance transplantation of this disadvantaged group of patients. Expert commentary: For highly sensitized patients, special attention is required, for which several strategies may apply. A step-wise approach may be the optimal strategy to facilitate successful transplantation of highly sensitized patients.
高度致敏的患者在等待肾移植时会被列入移植等待名单。该亚群患者的 HLA 抗体种类繁多，使得他们无法在可接受的时间内通过常规分配获得匹配的器官。 涵盖领域：对于这些患者，存在几种替代的移植选择，包括在常规分配中获得额外的优先权、基于可接受抗原进行分配的特殊计划、配对肾脏捐赠计划、脱敏方案，或后两者的组合。在这篇综述中，讨论了这些选择及其结果，以及进一步增强这个处于不利地位的患者群体移植的一些可能性。 专家评论：对于高度致敏的患者，需要特别关注，为此可能有几种策略可供选择。分阶段的方法可能是促进高度致敏患者成功移植的最佳策略。
