Desensitization With Imlifidase for HLA-Incompatible Deceased Donor Kidney Transplantation: A Delphi International Expert Consensus
Highly sensitized (HS) patients in need of kidney transplantation (KTx) typically spend a longer time waiting for compatible kidneys, are unlikely to receive an organ offer, and are at increased risk of antibody-mediated rejection (AMR). Desensitization using imlifidase, which is more rapid and remo...
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Frontiers Media S.A.
2025-01-01
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| author | Lucrezia Furian Uwe Heemann Mats Bengtsson Oriol Bestard Isabelle Binet Georg A. Böhmig John Boletis David Briggs Frans H. J. Claas Lionel Couzi Emanuele Cozzi Marta Crespo Aiko P. J. De Vries Fritz Diekmann Magdalena Durlik Denis Glotz Ilkka Helantera Annette Jackson Stanley C. Jordan Dirk Kuypers Dirk Kuypers Carmen Lefaucheur Christophe Legendre Tomas Lorant Umberto Maggiore Nizam Mamode Smaragdi Marinaki Annick Massart Thomas Müller Rainer Oberbauer Lutz Renders Dave Roelen Jean-Luc Taupin Ondřej Viklický Angeliki Vittoraki Annelies E. de Weerd Maarten Naesens |
| author_facet | Lucrezia Furian Uwe Heemann Mats Bengtsson Oriol Bestard Isabelle Binet Georg A. Böhmig John Boletis David Briggs Frans H. J. Claas Lionel Couzi Emanuele Cozzi Marta Crespo Aiko P. J. De Vries Fritz Diekmann Magdalena Durlik Denis Glotz Ilkka Helantera Annette Jackson Stanley C. Jordan Dirk Kuypers Dirk Kuypers Carmen Lefaucheur Christophe Legendre Tomas Lorant Umberto Maggiore Nizam Mamode Smaragdi Marinaki Annick Massart Thomas Müller Rainer Oberbauer Lutz Renders Dave Roelen Jean-Luc Taupin Ondřej Viklický Angeliki Vittoraki Annelies E. de Weerd Maarten Naesens |
| author_sort | Lucrezia Furian |
| collection | DOAJ |
| description | Highly sensitized (HS) patients in need of kidney transplantation (KTx) typically spend a longer time waiting for compatible kidneys, are unlikely to receive an organ offer, and are at increased risk of antibody-mediated rejection (AMR). Desensitization using imlifidase, which is more rapid and removes total body immunoglobulin G (IgG) to a greater extent than other methods, enables transplantation to occur between HLA-incompatible (HLAi) donor–recipient pairs and allows patients to have greater access to KTx. However, when the project was launched there was limited data and clinical experience with desensitization in general and with imlifidase specifically. Hence, this Delphi methodology was used to reach a consensus from a multi-disciplinary team (MDT) of experts from 15 countries on the management of HS patients undergoing imlifidase HLAi from a deceased donor (DD) KTx. This Delphi consensus provides clinical practice guidance on the use of imlifidase in the end-to-end management of HS patients undergoing an HLAi DD KTx and supports centers in the development of guidelines for the utilization and integration of imlifidase into clinical practice. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| spelling | doaj-art-7a7e636d154148be84ffb8f31a6b03fc2025-01-10T15:42:35ZengFrontiers Media S.A.Transplant International1432-22772025-01-013710.3389/ti.2024.1388613886Desensitization With Imlifidase for HLA-Incompatible Deceased Donor Kidney Transplantation: A Delphi International Expert ConsensusLucrezia Furian0Uwe Heemann1Mats Bengtsson2Oriol Bestard3Isabelle Binet4Georg A. Böhmig5John Boletis6David Briggs7Frans H. J. Claas8Lionel Couzi9Emanuele Cozzi10Marta Crespo11Aiko P. J. De Vries12Fritz Diekmann13Magdalena Durlik14Denis Glotz15Ilkka Helantera16Annette Jackson17Stanley C. Jordan18Dirk Kuypers19Dirk Kuypers20Carmen Lefaucheur21Christophe Legendre22Tomas Lorant23Umberto Maggiore24Nizam Mamode25Smaragdi Marinaki26Annick Massart27Thomas Müller28Rainer Oberbauer29Lutz Renders30Dave Roelen31Jean-Luc Taupin32Ondřej Viklický33Angeliki Vittoraki34Annelies E. de Weerd35Maarten Naesens36Kidney and Pancreas Transplantation Unit, Department of Surgery, Oncology and Gastroenterology DISCOG, University Hospital of Padova, Padova, ItalyAbteilung für Nephrologie, Klinikum Rechts der Isar, Technische Universität München, Munich, GermanyDepartment of Immunology, Genetics and Pathology, Uppsala University, Uppsala, SwedenNephrology and Kidney Transplant Department, Vall d’Hebron University Hospital, Barcelona, SpainClinic of Nephrology and Transplantation Medicine, Cantonal Hospital St Gallen, St. Gallen, SwitzerlandDivision of Nephrology and Dialysis, Department of Medicine III, Medical University Vienna, Vienna, AustriaDepartment of Nephrology and Renal Transplantation, National and Kapodistrian University of Athens, Laiko Hospital, Athens, GreeceHistocompatibility and Immunogenetics Laboratory, Birmingham Centre, NHS Blood and Transplant, UK NHS Blood and Transplant, Birmingham, United KingdomEurotransplant Reference Laboratory, Department of Immunohaematology and Blood Transfusion, Leiden University Medical Center, Albinusdreef, Netherlands0Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France1Transplant Immunology Unit, Department of Cardiac, National Transplant Centre (CNT), Thoracic and Vascular Sciences Padua University Hospital - Ospedale Giustinianeo, Padova, Italy2Department of Nephrology, Hospital del Mar, Nephropathies Research Group, Hospital del Mar Research Institute, Barcelona, Spain3Division of Nephrology, Department of Medicine, and Leiden Transplant Center, Leiden University Medical Center, Leiden, Netherlands4Department of Nephrology and Kidney Transplantation, Hospital Clínic Barcelona, Barcelona, Spain5Klinika Transplantologii, Immunologii, Nefrologii i Chorób Wewnętrznych Warszawski Uniwersytet Medyczny ul, Warszawa, Poland6Department of Nephrology and Renal Transplantation, Saint-Louis Hospital in Paris, Paris, France7Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland8Department of Surgery, Duke University, Durham, NC, United States9Nephrology and Transplant Immunology Medical Director Kidney Transplant Program Cedars-Sinai Medical Center, Pediatrics and Medicine David Geffen School of Medicine at UCLA, Los Angeles, CA, United States0Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium1Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium2Nephrologist and Head of the Nephrology and Kidney Transplantation Department, Saint-Louis Hospital-APHP, Paris, France3Nephrology at Université Paris Cité and Head of Nephrology and Transplantation Unit at Necker Hospital in Paris, Paris, France4Uppsala University, Department of Surgical Sciences, Section of Transplant Surgery, Uppsala, Sweden5Dipartimento di Medicina e Chirurgia, Università di Parma, UO Nefrologia - Trapianti Rene Pancreas, Programma Regionale Trapianti Emilia-Romagna, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy6Department of Transplantation, Transplant Surgery at Guy’s and Great Ormond Street Hospitals, London, United Kingdom7National and Kapodistrian University of Athens, Clinic of Nephrology and Transplantation, “Laiko” General Hospital, Athens, Greece8Department of Nephrology, UZ Antwerpen, Antwerpen, Belgium9Clinic for Nephrology, Renal Transplant Program, Transplant Institute, University Hospital Zurich, Zurich, Switzerland0Medical University of Vienna, Vienna, Austria1Department of Nephrology of Technische Universität München, München (TUM), Munich, Germany2Department of Immunology, Leiden University Medical Center, Leiden, Netherlands3Laboratory of Immunology and Histocompatibility, Hôpital Saint-Louis, APHP Paris, Paris, France4Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czechia5Immunology Department and National Tissue Typing Center, “G.Gennimatas” Hospital, Athens, Greece6Erasmus MC Transplant Institute, Department of Internal Medicine, University Medical Center, Rotterdam, Netherlands1Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, BelgiumHighly sensitized (HS) patients in need of kidney transplantation (KTx) typically spend a longer time waiting for compatible kidneys, are unlikely to receive an organ offer, and are at increased risk of antibody-mediated rejection (AMR). Desensitization using imlifidase, which is more rapid and removes total body immunoglobulin G (IgG) to a greater extent than other methods, enables transplantation to occur between HLA-incompatible (HLAi) donor–recipient pairs and allows patients to have greater access to KTx. However, when the project was launched there was limited data and clinical experience with desensitization in general and with imlifidase specifically. Hence, this Delphi methodology was used to reach a consensus from a multi-disciplinary team (MDT) of experts from 15 countries on the management of HS patients undergoing imlifidase HLAi from a deceased donor (DD) KTx. This Delphi consensus provides clinical practice guidance on the use of imlifidase in the end-to-end management of HS patients undergoing an HLAi DD KTx and supports centers in the development of guidelines for the utilization and integration of imlifidase into clinical practice.https://www.frontierspartnerships.org/articles/10.3389/ti.2024.13886/fulldesensitizationHLA incompatibleHLAikidney transplantationimlifidase |
| spellingShingle | Lucrezia Furian Uwe Heemann Mats Bengtsson Oriol Bestard Isabelle Binet Georg A. Böhmig John Boletis David Briggs Frans H. J. Claas Lionel Couzi Emanuele Cozzi Marta Crespo Aiko P. J. De Vries Fritz Diekmann Magdalena Durlik Denis Glotz Ilkka Helantera Annette Jackson Stanley C. Jordan Dirk Kuypers Dirk Kuypers Carmen Lefaucheur Christophe Legendre Tomas Lorant Umberto Maggiore Nizam Mamode Smaragdi Marinaki Annick Massart Thomas Müller Rainer Oberbauer Lutz Renders Dave Roelen Jean-Luc Taupin Ondřej Viklický Angeliki Vittoraki Annelies E. de Weerd Maarten Naesens Desensitization With Imlifidase for HLA-Incompatible Deceased Donor Kidney Transplantation: A Delphi International Expert Consensus Transplant International desensitization HLA incompatible HLAi kidney transplantation imlifidase |
| title | Desensitization With Imlifidase for HLA-Incompatible Deceased Donor Kidney Transplantation: A Delphi International Expert Consensus |
| title_full | Desensitization With Imlifidase for HLA-Incompatible Deceased Donor Kidney Transplantation: A Delphi International Expert Consensus |
| title_fullStr | Desensitization With Imlifidase for HLA-Incompatible Deceased Donor Kidney Transplantation: A Delphi International Expert Consensus |
| title_full_unstemmed | Desensitization With Imlifidase for HLA-Incompatible Deceased Donor Kidney Transplantation: A Delphi International Expert Consensus |
| title_short | Desensitization With Imlifidase for HLA-Incompatible Deceased Donor Kidney Transplantation: A Delphi International Expert Consensus |
| title_sort | desensitization with imlifidase for hla incompatible deceased donor kidney transplantation a delphi international expert consensus |
| topic | desensitization HLA incompatible HLAi kidney transplantation imlifidase |
| url | https://www.frontierspartnerships.org/articles/10.3389/ti.2024.13886/full |
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