COUZI, Lionel; MALVEZZI, P.; AMROUCHE, L.; ANGLICHEAU, D.; BLANCHO, G.; CAILLARD, S.; FREIST, M.; GUIDICELLI, G.L.; KAMAR, N.; LEFAUCHEUR, C.; MARIAT, C.; KOENIG, A.; NOBLE, J.; THAUNAT, O.; THIERRY, A.; TAUPIN, J.-L.; BERTRAND, D.

doi:10.3389/ti.2023.11244

COUZI, Lionel
Immunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle [ImmunoConcept]

MALVEZZI, P.

AMROUCHE, L.

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Article de revue

Ce document a été publié dans

Transplant International. 2023, vol. 36

Résumé en anglais

Imlifidase recently received early access authorization for highly sensitized adult kidney transplant candidates with a positive crossmatch against an ABO-compatible deceased donor. These French consensus guidelines have been generated by an expert working group, in order to homogenize patient selection, associated treatments and follow-up. This initiative is part of an international effort to analyze properly the benefits and tolerance of this new costly treatment in real-life. Eligible patients must meet the following screening criteria: cPRA ≥ 98%, ≤ 65-year of age, ≥ 3 years on the waiting list, and a low risk of biopsy-related complications. The final decision to use Imlifidase will be based on the two following criteria. First, the results of a virtual crossmatch on recent serum, which shall show a MFI for the immunodominant donor-specific antibodies (DSA) > 6,000 but the value of which does not exceed 5,000 after 1:10 dilution. Second, the post-Imlifidase complement-dependent cytotoxicity crossmatch must be negative. Patients treated with Imlifidase will receive an immunosuppressive regimen based on steroids, rATG, high dose IVIg, rituximab, tacrolimus and mycophenolic acid. Frequent post-transplant testing for DSA and systematic surveillance kidney biopsies are highly recommended to monitor post-transplant DSA rebound and subclinical rejection.< Réduire

Mots clés en anglais

Kidney transplantation

Desensitization

Imlifidase

Highly sensitized patients

Positive crossmatch

URI

https://oskar-bordeaux.fr/handle/20.500.12278/201799

DOI

http://dx.doi.org/10.3389/ti.2023.11244

Unités de recherche

ImmunoConcEpT - UMR 5164

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Imlifidase for Kidney Transplantation of Highly Sensitized Patients With a Positive Crossmatch: The French Consensus Guidelines

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Résumé en anglais

Mots clés en anglais

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