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HLA Desensitization With IVIg Facilitates Kidney Transplant

Investigators successfully transplanted 13 kidneys into a group of 15 patients who were treated with intravenous immunoglobulin (IVIg) for HLA desensitization, according to a report of a pilot study in the September issue of the American Journal of Transplantation.

“Transplantation of patients possessing antibodies against allo-HLA antigens can be delayed for years,” write Denis Glotz, from the Hôpital Européen Georges Pompidou in Paris, France, and colleagues. “We have shown that administration of [IVIg] can induce a profound and sustained decrease in the titers of anti-HLA antibodies.”

 Of 15 patients with antibodies against allo-HLA who were treated with IVIg, given as three monthly courses of 2 g/kg body weight, 13 patients (87%) were effectively desensitized and underwent immediate transplantation, 11 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. At follow-up of at least one year, all other patients remained free of rejection episodes or other complications.

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