Desensitization protocols for prospective pediatric renal transplant recipients.
Desensitization protocols should be considered for children with positive crossmatches awaiting renal transplantation. Children are sensitized usually due to previous renal (and/or other solid-organ) transplants but can be from administration of blood and/or platelet transfusions, infections, and immunizations (as sensitization from pregnancy is a rare occurrence in pediatric patients). However, the definition of HLA-incompatible (HLAi) renal transplantation in the literature varies and is best considered only when there is a positive cross-match (positive baseline flow cytometric cross-match or positive complement-dependent cytotoxic cross-match). Renal transplantation where the recipient has donor-specific antibodies (DSA) but a negative cross-match should not fall into this category, although they are higher risk.
Department of Transplantation, Guy's and St Thomas' NHS Foundation Trust, London, SE1 9RT, UK. nizam.mamode@gstt.nhs.uk.|Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK. nizam.mamode@gstt.nhs.uk.
Nizam
N
Mamode
Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK.
Stephen D
SD
Marks
D002648:Child; D003888:Desensitization, Immunologic / Q000379:methods*; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*
D006680:HLA Antigens
Children; Cumulative reaction frequency; HLA incompatible; Panel reactive antibody; Renal transplantation