title: Desensitization protocol enabling pediatric crossmatch-positive renal transplantation: successful HLA-antibody-incompatible renal transplantation of two highly sensitized children.
abstract: Renal transplantation improves quality of life (QoL) and survival in children requiring renal replacement therapy (RRT). Sensitization with development of a broad-spectrum of anti-HLA antibodies as a result of previous transplantation or after receiving blood products is an increasing problem. There are no published reports of desensitization protocols in children allowing renal transplantation from HLA-antibody-incompatible living donors.
  
  
  
  We adopted our well-established adult desensitization protocol for this purpose and undertook HLA antibody-incompatible living donor renal transplants in two children: a 14-year-old girl and a 13-year-old boy.
  
  
  
  After 2 and 1.5 years of follow-up, respectively, both patients have stable renal allograft function despite a rise in donor-specific antibodies in one case.
  
  
  
  HLA-incompatible transplantation should be considered in selected cases for sensitized children.
authors: Department of Transplantation at Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, 6th Floor, Borough Wing, SE1 9RT, London, UK.
authors: Anna M
authors: AM
authors: Adamusiak
authors: Department of Paediatric Nephrology at Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
authors: Jelena
authors: J
authors: Stojanovic
authors: Clinical Transplantation Laboratory at Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors: Olivia
authors: O
authors: Shaw
authors: Clinical Transplantation Laboratory at Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors: Robert
authors: R
authors: Vaughan
authors: Department of Paediatric Nephrology at Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
authors: Neil J
authors: NJ
authors: Sebire
authors: Department of Transplantation at Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, 6th Floor, Borough Wing, SE1 9RT, London, UK.|Department of Paediatric Nephrology at Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
authors: Martin
authors: M
authors: Drage
authors: Department of Transplantation at Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, 6th Floor, Borough Wing, SE1 9RT, London, UK.|Department of Paediatric Nephrology at Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
authors: Nicos
authors: N
authors: Kessaris
authors: Department of Paediatric Nephrology at Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
authors: Stephen D
authors: SD
authors: Marks
authors: Department of Transplantation at Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, 6th Floor, Borough Wing, SE1 9RT, London, UK. nizam.mamode@gstt.nhs.uk.|Department of Paediatric Nephrology at Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. nizam.mamode@gstt.nhs.uk.
authors: Nizam
authors: N
authors: Mamode
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology; D000293:Adolescent; D001788:Blood Grouping and Crossmatching / Q000379:methods*; D003888:Desensitization, Immunologic / Q000379:methods*; D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D010956:Plasmapheresis; D011788:Quality of Life
chemical_list: D000017:ABO Blood-Group System; D006680:HLA Antigens
keywords: Antibody-incompatible HLA; Desensitization; Pediatric; Transplantation