Desensitization and subsequent kidney transplantation of patients using intravenous immunoglobulins (IVIg).
Transplantation of patients possessing antibodies against allo-HLA antigens can be delayed for years. We have shown that administration of intravenous immunoglobulins (IVIg) can induce a profound and sustained decrease in the titers of anti-HLA antibodies. We report here the first series of patients desensitized, then transplanted using IVIg therapy. Fifteen patients have been included and treated with IVIg, given as 3 monthly courses of 2g/kg body weight. Thirteen of those 15 patients (87%) were effectively desensitized and underwent immediate transplantation. Eleven were transplanted with a cadaveric donor, and two with a living donor against which the pretreatment cross-match was positive. One graft was lost from thrombosis and one from rejection. All other patients had uneventful courses, without any episodes of rejection, with a follow-up of more than 1 year. Thus, IVIg therapy allows safe and prompt kidney transplantation of immunized patients.
Glotz
Denis
D
Department of Nephrology, INSERM U 430, Hĵpital Européen Georges Pompidou, Paris, France. denis.glotz@egp.ap-hop-paris.fr
Antoine
Corinne
C
Julia
Pierre
P
Suberbielle-Boissel
Caroline
C
Boudjeltia
Samir
S
Fraoui
Rabah
R
Hacen
Chafic
C
Duboust
Alain
A
Bariety
Jean
J
D000293:Adolescent; D000328:Adult; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000494:pharmacology* / Q000627:therapeutic use; D016030:Kidney Transplantation; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome
D016756:Immunoglobulins, Intravenous