Repository for Antibody Incompatible Transplantation Evidence

Desensitization and subsequent kidney transplantation of patients using intravenous immunoglobulins (IVIg)

Am J Transplant. 2002 Sep;2(8):758-60 doi: 10.1034/j.1600-6143.2002.20809.x.

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.

LEVEL OF EVIDENCE: Case Series / Case Control / Cohort
MESH HEADINGS: Adolescent; Adult; Graft Rejection; Humans; Immunoglobulins, Intravenous; Kidney Transplantation; Middle Aged; Pilot Projects; Treatment Outcome