Achieving incompatible transplantation through desensitization: current perspectives and future directions
The application of life-saving transplantation is severely limited by the shortage of organs, and histoincompatibility. To increase transplant rates in sensitized patients, new protocols for HLA and blood type incompatible (ABOi) desensitization have emerged. These approaches require significant des...
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| Veröffentlicht in: | Immunotherapy 2015-04, Vol.7 (4), p.377-398 |
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| creator | Jordan, Stanley C Choi, Jua Vo, Ashley |
| description | The application of life-saving transplantation is severely limited by the shortage of organs, and histoincompatibility. To increase transplant rates in sensitized patients, new protocols for HLA and blood type incompatible (ABOi) desensitization have emerged. These approaches require significant desensitization using intravenous immunoglobulin, rituximab and plasma exchange. In addition, the development of donor-specific antibody responses post transplant is the major cause of allograft failure with return to dialysis. This increases patient morbidity/mortality and cost. Immunotherapeutic agents used for desensitization evolved from drug development in oncology and autoimmune diseases. Currently, there is a renaissance in development of novel drugs likely to improve antibody reduction in transplantation. These include agents that inactivate IgG molecules, anticytokine antibodies, costimulatory molecule blockade, anticomplement agents and therapies aimed at the plasma cell. |
| doi_str_mv | 10.2217/imt.15.10 |
| format | Article |
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To increase transplant rates in sensitized patients, new protocols for HLA and blood type incompatible (ABOi) desensitization have emerged. These approaches require significant desensitization using intravenous immunoglobulin, rituximab and plasma exchange. In addition, the development of donor-specific antibody responses post transplant is the major cause of allograft failure with return to dialysis. This increases patient morbidity/mortality and cost. Immunotherapeutic agents used for desensitization evolved from drug development in oncology and autoimmune diseases. Currently, there is a renaissance in development of novel drugs likely to improve antibody reduction in transplantation. These include agents that inactivate IgG molecules, anticytokine antibodies, costimulatory molecule blockade, anticomplement agents and therapies aimed at the plasma cell.</description><identifier>ISSN: 1750-743X</identifier><identifier>EISSN: 1750-7448</identifier><identifier>DOI: 10.2217/imt.15.10</identifier><identifier>PMID: 25917629</identifier><language>eng</language><publisher>England: Future Medicine Ltd</publisher><subject>Animals ; Antibodies, Monoclonal - therapeutic use ; Antigens ; B cells ; Blood transfusions ; complement inhibition ; Complications and side effects ; Cytokines ; desensitization ; Graft Rejection - etiology ; Graft Rejection - prevention & control ; Health aspects ; Hemodialysis ; Histocompatibility ; HLA ; HLA Antigens ; Humans ; IL-6 receptor ; Immune response ; Immune system ; Immunoglobulins, Intravenous - therapeutic use ; Immunotherapy ; Immunotherapy - methods ; Immunotherapy - trends ; IVIg ; Kidney transplantation ; Lymphocytes ; Medical research ; Organ Transplantation ; Plasma ; Plasma Exchange ; Psoriasis ; rituximab ; Rituximab - therapeutic use ; Transplantation Tolerance ; Transplants & implants</subject><ispartof>Immunotherapy, 2015-04, Vol.7 (4), p.377-398</ispartof><rights>COPYRIGHT 2015 Future Medicine Ltd.</rights><rights>2015 Future Medicine Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-7c0aacc8eb79a3b12d042d205a8b5c78cdb7af8a49baa98f43a51b74766048c53</citedby><cites>FETCH-LOGICAL-c451t-7c0aacc8eb79a3b12d042d205a8b5c78cdb7af8a49baa98f43a51b74766048c53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25917629$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jordan, Stanley C</creatorcontrib><creatorcontrib>Choi, Jua</creatorcontrib><creatorcontrib>Vo, Ashley</creatorcontrib><title>Achieving incompatible transplantation through desensitization: current perspectives and future directions</title><title>Immunotherapy</title><addtitle>Immunotherapy</addtitle><description>The application of life-saving transplantation is severely limited by the shortage of organs, and histoincompatibility. To increase transplant rates in sensitized patients, new protocols for HLA and blood type incompatible (ABOi) desensitization have emerged. These approaches require significant desensitization using intravenous immunoglobulin, rituximab and plasma exchange. In addition, the development of donor-specific antibody responses post transplant is the major cause of allograft failure with return to dialysis. This increases patient morbidity/mortality and cost. Immunotherapeutic agents used for desensitization evolved from drug development in oncology and autoimmune diseases. Currently, there is a renaissance in development of novel drugs likely to improve antibody reduction in transplantation. These include agents that inactivate IgG molecules, anticytokine antibodies, costimulatory molecule blockade, anticomplement agents and therapies aimed at the plasma cell.</description><subject>Animals</subject><subject>Antibodies, Monoclonal - therapeutic use</subject><subject>Antigens</subject><subject>B cells</subject><subject>Blood transfusions</subject><subject>complement inhibition</subject><subject>Complications and side effects</subject><subject>Cytokines</subject><subject>desensitization</subject><subject>Graft Rejection - etiology</subject><subject>Graft Rejection - prevention & control</subject><subject>Health aspects</subject><subject>Hemodialysis</subject><subject>Histocompatibility</subject><subject>HLA</subject><subject>HLA Antigens</subject><subject>Humans</subject><subject>IL-6 receptor</subject><subject>Immune response</subject><subject>Immune system</subject><subject>Immunoglobulins, Intravenous - therapeutic use</subject><subject>Immunotherapy</subject><subject>Immunotherapy - methods</subject><subject>Immunotherapy - trends</subject><subject>IVIg</subject><subject>Kidney transplantation</subject><subject>Lymphocytes</subject><subject>Medical research</subject><subject>Organ Transplantation</subject><subject>Plasma</subject><subject>Plasma Exchange</subject><subject>Psoriasis</subject><subject>rituximab</subject><subject>Rituximab - therapeutic use</subject><subject>Transplantation Tolerance</subject><subject>Transplants & implants</subject><issn>1750-743X</issn><issn>1750-7448</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNptkU9r3DAQxUVpaf60h3yBIOiph91KsmTZuS2hTQOBXlroTcjj8a6WteRIcqD59FXiNKEQdJDm8XsjjR4hZ5ytheD6ixvzmqs1Z2_IMdeKrbSUzdvnc_X7iJyktGeslrqW78mRUC3XtWiPyX4DO4d3zm-p8xDGyWbXHZDmaH2aDtbnIgRP8y6GebujPSb0yWV3_6hfUJhjRJ_phDFNCNndYaLW93SY8xyR9i4-qMGnD-TdYA8JPz7tp-TXt68_L7-vbn5cXV9ublYgFc8rDcxagAY73dqq46JnUvSCKdt0CnQDfaft0FjZdta2zSArq3iny2Q1kw2o6pR8WvpOMdzOmLLZhzn6cqXhta5ZrbhuX6itPaBxfghlZBhdArORnFdCKCEKtX6FKqvH0UHwOLii_2f4vBgghpQiDmaKbrTxj-HMPIRlSliGq1IW9vzpoXM3Yv9M_kunAGoBlr9M4NADmqUqDgfO4yuN_wLPrqQq</recordid><startdate>20150401</startdate><enddate>20150401</enddate><creator>Jordan, Stanley C</creator><creator>Choi, Jua</creator><creator>Vo, Ashley</creator><general>Future Medicine Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>EHMNL</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20150401</creationdate><title>Achieving incompatible transplantation through desensitization: current perspectives and future directions</title><author>Jordan, Stanley C ; Choi, Jua ; Vo, Ashley</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c451t-7c0aacc8eb79a3b12d042d205a8b5c78cdb7af8a49baa98f43a51b74766048c53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Animals</topic><topic>Antibodies, Monoclonal - therapeutic use</topic><topic>Antigens</topic><topic>B cells</topic><topic>Blood transfusions</topic><topic>complement inhibition</topic><topic>Complications and side effects</topic><topic>Cytokines</topic><topic>desensitization</topic><topic>Graft Rejection - etiology</topic><topic>Graft Rejection - prevention & control</topic><topic>Health aspects</topic><topic>Hemodialysis</topic><topic>Histocompatibility</topic><topic>HLA</topic><topic>HLA Antigens</topic><topic>Humans</topic><topic>IL-6 receptor</topic><topic>Immune response</topic><topic>Immune system</topic><topic>Immunoglobulins, Intravenous - therapeutic use</topic><topic>Immunotherapy</topic><topic>Immunotherapy - methods</topic><topic>Immunotherapy - trends</topic><topic>IVIg</topic><topic>Kidney transplantation</topic><topic>Lymphocytes</topic><topic>Medical research</topic><topic>Organ Transplantation</topic><topic>Plasma</topic><topic>Plasma Exchange</topic><topic>Psoriasis</topic><topic>rituximab</topic><topic>Rituximab - therapeutic use</topic><topic>Transplantation Tolerance</topic><topic>Transplants & implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jordan, Stanley C</creatorcontrib><creatorcontrib>Choi, Jua</creatorcontrib><creatorcontrib>Vo, Ashley</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>UK & Ireland Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Immunotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jordan, Stanley C</au><au>Choi, Jua</au><au>Vo, Ashley</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Achieving incompatible transplantation through desensitization: current perspectives and future directions</atitle><jtitle>Immunotherapy</jtitle><addtitle>Immunotherapy</addtitle><date>2015-04-01</date><risdate>2015</risdate><volume>7</volume><issue>4</issue><spage>377</spage><epage>398</epage><pages>377-398</pages><issn>1750-743X</issn><eissn>1750-7448</eissn><abstract>The application of life-saving transplantation is severely limited by the shortage of organs, and histoincompatibility. To increase transplant rates in sensitized patients, new protocols for HLA and blood type incompatible (ABOi) desensitization have emerged. These approaches require significant desensitization using intravenous immunoglobulin, rituximab and plasma exchange. In addition, the development of donor-specific antibody responses post transplant is the major cause of allograft failure with return to dialysis. This increases patient morbidity/mortality and cost. Immunotherapeutic agents used for desensitization evolved from drug development in oncology and autoimmune diseases. Currently, there is a renaissance in development of novel drugs likely to improve antibody reduction in transplantation. 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| subjects | Animals Antibodies, Monoclonal - therapeutic use Antigens B cells Blood transfusions complement inhibition Complications and side effects Cytokines desensitization Graft Rejection - etiology Graft Rejection - prevention & control Health aspects Hemodialysis Histocompatibility HLA HLA Antigens Humans IL-6 receptor Immune response Immune system Immunoglobulins, Intravenous - therapeutic use Immunotherapy Immunotherapy - methods Immunotherapy - trends IVIg Kidney transplantation Lymphocytes Medical research Organ Transplantation Plasma Plasma Exchange Psoriasis rituximab Rituximab - therapeutic use Transplantation Tolerance Transplants & implants |
| title | Achieving incompatible transplantation through desensitization: current perspectives and future directions |
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