https://www.austinpublishinggroup.com/transplantation-sciences/
HLAIncompatible (HLAI) renal transplantation with desensitization is being
increasingly performed in Northern Ireland because it results in better quality
of life and improved survival compared to long term maintenance dialysis. Risk
stratification for potential recipients in the United Kingdom is performed
according to British Society of Histocompatibility and Immunogenetics (BSHI) /
British Transplant Society (BTS) guidelines, which involves comprehensive
evaluation by a combination of Complement Dependent Cytotoxicity Cross-Match
(CDCXM), Flowcytometry Cross-Match (FCXM) and Luminex Single Antigen Bead (SAB)
assay, and correlation with sensitization history.
Transplantingsuccessfully across a broad specificity such as HLA- Bw4 or Bw6 may prove more
difficult, because non–DSA reacting with Bw4 or Bw6 epitopes could have an
additive effect and hence greater overall reactivity even if reactivity against
the donor mismatched allele is low. In this paper the workup leading to
successful outcome of two HLAI transplants performed in Belfast City Hospital
is presented. Maintenance immunosuppression was with the triple drug regimen of
Prednisolone, Mycophenolate Mofetil (MMF) and Tacrolimus.
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