Presensitization: the problem and its management. Export

@article{citeulike:3079216, abstract = {Much attention has been placed recently on transplantation in highly HLA-sensitized patients. In attempts to remove these antibodies and enable successful transplantation, several novel approaches have been developed. These include intravenous Ig (IVIg), mycophenolate mofetil, sirolimus, alemtuzumab, protein A immunoabsorption, and rituximab. IVIg has emerged as a very effective agent when used alone in high dose or when used in low dose and combined with plasmapheresis. Although alemtuzumab has been used to eliminated B cells, it fails to prevent antibody-mediated rejection and therefore probably is not suitable for desensitization. Rituximab, a B cell-specific antibody, seems to be safe and to have some efficacy as a sole agent in elimination of alloantibodies but most likely will require combination therapy with IVIg or other agents. Newer agents, such as humanized anti-CD20, are being developed. Despite the great interest in the problem of allosensitization, with one notable exception, there is a major deficiency in controlled clinical trials, the conduct of which should be a focus for the near future.}, address = {Transplant Immunology Laboratory, Cedars-Sinai Medical Center, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California 90048, USA. sjordan@cshs.org}, author = {Jordan, S. C. and Pescovitz, M. D.}, citeulike-article-id = {3079216}, citeulike-linkout-0 = {http://dx.doi.org/10.2215/CJN.01651105}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/17699241}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=17699241}, doi = {10.2215/CJN.01651105}, issn = {1555-905X}, journal = {Clinical journal of the American Society of Nephrology : CJASN}, keywords = {densentization}, month = {May}, number = {3}, pages = {421--432}, posted-at = {2008-08-04 01:50:09}, priority = {0}, title = {Presensitization: the problem and its management.}, url = {http://dx.doi.org/10.2215/CJN.01651105}, volume = {1}, year = {2006} }

TY - JOUR ID - citeulike:3079216 L3 - citeulike-article-id:3079216 N2 - Much attention has been placed recently on transplantation in highly HLA-sensitized patients. In attempts to remove these antibodies and enable successful transplantation, several novel approaches have been developed. These include intravenous Ig (IVIg), mycophenolate mofetil, sirolimus, alemtuzumab, protein A immunoabsorption, and rituximab. IVIg has emerged as a very effective agent when used alone in high dose or when used in low dose and combined with plasmapheresis. Although alemtuzumab has been used to eliminated B cells, it fails to prevent antibody-mediated rejection and therefore probably is not suitable for desensitization. Rituximab, a B cell-specific antibody, seems to be safe and to have some efficacy as a sole agent in elimination of alloantibodies but most likely will require combination therapy with IVIg or other agents. Newer agents, such as humanized anti-CD20, are being developed. Despite the great interest in the problem of allosensitization, with one notable exception, there is a major deficiency in controlled clinical trials, the conduct of which should be a focus for the near future. IS - 3 JF - Clinical journal of the American Society of Nephrology : CJASN SN - 1555-905X AD - Transplant Immunology Laboratory, Cedars-Sinai Medical Center, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California 90048, USA. sjordan@cshs.org EP - 432 TI - Presensitization: the problem and its management. VL - 1 SP - 421 KW - densentization AU - Jordan, SC AU - Pescovitz, MD PY - 2006/05// UR - http://dx.doi.org/10.2215/CJN.01651105 ER -