Strategies for Access to Kidney Transplantation for Highly Sensitized and Incompatible Patients

A special issue of Transplantology (ISSN 2673-3943).

Deadline for manuscript submissions: 31 December 2024 | Viewed by 4047

Special Issue Editor


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Guest Editor
Department of Transplantation—Renal Unit, Careggi University Hospital, 50139 Florence, Italy
Interests: immunology; renal transplantation; epidemiology; coronavirus infection; organ transplantation
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Special Issue Information

Dear Colleagues,

Historically, the lack of adequate strategies and powerful immunosuppressants make it impossible or an unacceptable risk level for kidney transplant in highly immunized patients or in the case of AB0 incompatible pairs. The aim of this Special Issue is to describe new strategies and new drugs that allow for such high-risk transplantation. Several trials are, to date, ongoing and should be described in detail. We are soliciting papers describing these new drugs as well as new strategies. Strategies related to the Exchange Programmes (KEP) should also be the object of some papers. In particular, KEP allows transplantation between AB0 incompatible pairs.

Prof. Dr. Maurizio Salvadori
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Transplantology is an international peer-reviewed open access quarterly journal published by MDPI.

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Keywords

  • desensitization
  • sensitized patients
  • kidney transplantation
  • AB0 incompatible patients
  • kidney exchange programmes

Published Papers (2 papers)

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Editorial

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5 pages, 753 KiB  
Editorial
Strategies for Access to Kidney Transplantation for Highly Sensitized and Incompatible Patients
by Maurizio Salvadori
Transplantology 2023, 4(2), 85-89; https://doi.org/10.3390/transplantology4020009 - 22 May 2023
Cited by 2 | Viewed by 1472
Abstract
One of the major challenges in developing programs for kidney transplantation is represented by the presence of antibodies targeting the HLA of the donor in the recipients and, in particular cases, the incompatibility of the ABO blood groups among donor and recipient for [...] Read more.
One of the major challenges in developing programs for kidney transplantation is represented by the presence of antibodies targeting the HLA of the donor in the recipients and, in particular cases, the incompatibility of the ABO blood groups among donor and recipient for living donors [...] Full article
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Review

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12 pages, 521 KiB  
Review
Update on Desensitization Strategies and Drugs on Hyperimmune Patients for Kidney Transplantation
by Maurizio Salvadori
Transplantology 2023, 4(3), 139-150; https://doi.org/10.3390/transplantology4030014 - 8 Aug 2023
Cited by 1 | Viewed by 2148
Abstract
The presence in a recipient of antibodies directed against donor-specific antigens represents a major obstacle to transplantation. Removal of these antibodies represents a challenge for physicians dealing with kidney transplantation. Several strategies, techniques, and old and new drugs are currently used for desensitizing [...] Read more.
The presence in a recipient of antibodies directed against donor-specific antigens represents a major obstacle to transplantation. Removal of these antibodies represents a challenge for physicians dealing with kidney transplantation. Several strategies, techniques, and old and new drugs are currently used for desensitizing these patients. Desensitization may either occur before transplantation, at the time of transplantation, or after transplantation according to whether physicians are dealing with living or deceased donors. Different techniques may be used to reveal the presence of antibodies in the recipients; each technique has different sensitivities and specificities, and different advantages and drawbacks. The targets of the drugs used to desensitize are B cells, plasma cells, the antibodies themselves, and, finally, the complement that is the final actor causing tissue disruption. B cells are relatively easy to target; targeting the plasma cell is more difficult. Indeed, several new drugs are also used in randomized trials to defeat plasma cells. Antibodies may be removed easily, but their removal is often followed by antibody rebound. The complement is not easy to defeat and new drugs are currently used for this aim. Overall, despite difficulties, desensitization is currently possible in many cases, to obtain a safe and successful transplantation. Full article
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