Imlifidase in Highly Sensitized Kidney Transplant Recipients With a Positive Crossmatch Against a Deceased Donor
| dc.rights.license | open | en_US |
| dc.contributor.author | KAMAR, Nassim | |
| dc.contributor.author | BERTRAND, Dominique | |
| dc.contributor.author | CAILLARD, Sophie | |
| dc.contributor.author | PIEVANI, Danièle | |
| dc.contributor.author | APITHY, Marie Joelle | |
| dc.contributor.author | CONGY-JOLIVET, Nicolas | |
| hal.structure.identifier | Immunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle [ImmunoConcept] | |
| dc.contributor.author | CHAUVEAU, Bertrand | |
| dc.contributor.author | FARCE, Fabienne | |
| dc.contributor.author | FRANÇOIS, Arnaud | |
| dc.contributor.author | DELAS, Audrey | |
| dc.contributor.author | OLAGNE, Jérôme | |
| dc.contributor.author | USUREAU, Cédric | |
| dc.contributor.author | TAUPIN, Jean-Luc | |
| dc.contributor.author | GUIDICELLI, Gwenda Line | |
| dc.contributor.author | COUZI, Lionel | |
| dc.date.accessioned | 2025-01-09T11:03:34Z | |
| dc.date.available | 2025-01-09T11:03:34Z | |
| dc.date.issued | 2024-10 | |
| dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/204217 | |
| dc.description.abstractEn | Imlifidase is authorized for desensitization of highly sensitized adult kidney transplant candidates with a positive crossmatch (XM) against a deceased donor. Here, we report on the results for the first 9 patients transplanted in this context who had at least 3 months of follow-up. Methods: The eligibility criteria were as follows: calculated panel reactive antibodies (cPRA) ³ 98%, ³ 3 years on the waiting list, immunodominant donor-specific antibodies (DSAs) with mean fluorescence intensity (MFI) > 6000 (and < 5000 at 1:10 dilution) and a negative post-imlifidase complement-dependent cytotoxic XM (CDCXM). Results: All 9 patients had been on dialysis for an average of 123 ± 41 months, with cPRA at 99% (n = 2) or 100% (n = 7). At transplantation, the mean number of DSAs was 4.3 ± 1.4. The median immunodominant DSA MFI was 9153 (6430–16,980). Flow cytometry XM (FCXM) and CDCXM before imlifidase were positive in 9 and 2 patients, respectively. After 1 injection of imlifidase, all were negative. Patients received polyclonal antibodies, i.v. Igs (IVIg), rituximab, tacrolimus, and mycophenolate. Five patients had a DSA rebound within the first 14 days: 2 had concomitant clinical antibody-mediated rejection (ABMR), 2 had subclinical ABMR, and 1 had isolated positive C4d staining. No ABMR was observed in patients without rebound. Chronic Kidney Disease-Epidemiology Collaboration formula estimated glomerular filtration rate (eGFR) was 56 ± 22 ml/min per 1.73 m2 at the last follow-up (7 ± 2.8 months). No graft loss or death were observed. Four patients developed at least 1 infection. Conclusion: These real-life data demonstrate that the use of imlifidase to desensitize highly sensitized patients can have an acceptable short-term efficacy and safety profile in selected patients. | |
| dc.language.iso | EN | en_US |
| dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | * |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
| dc.subject.en | Highly sensitized patients | |
| dc.subject.en | Imlifidase | |
| dc.subject.en | Kidney transplantation | |
| dc.subject.en | Positive crossmatch | |
| dc.title.en | Imlifidase in Highly Sensitized Kidney Transplant Recipients With a Positive Crossmatch Against a Deceased Donor | |
| dc.type | Article de revue | en_US |
| dc.identifier.doi | 10.1016/j.ekir.2024.07.024 | en_US |
| dc.subject.hal | Sciences du Vivant [q-bio]/Immunologie | en_US |
| dc.identifier.pubmed | 39430184 | en_US |
| bordeaux.journal | Kidney International Reports | en_US |
| bordeaux.page | 2927 – 2936 | en_US |
| bordeaux.volume | 9 | en_US |
| bordeaux.hal.laboratories | ImmunoConcEpT - UMR 5164 | en_US |
| bordeaux.issue | 10 | en_US |
| bordeaux.institution | Université de Bordeaux | en_US |
| bordeaux.institution | CNRS | en_US |
| bordeaux.peerReviewed | oui | en_US |
| bordeaux.inpress | non | en_US |
| hal.identifier | hal-04876538 | |
| hal.version | 1 | |
| hal.date.transferred | 2025-01-09T11:03:38Z | |
| hal.popular | non | en_US |
| hal.audience | Internationale | en_US |
| hal.export | true | |
| dc.rights.cc | CC BY-NC-ND | en_US |
| bordeaux.COinS | ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Kidney%20International%20Reports&rft.date=2024-10&rft.volume=9&rft.issue=10&rft.spage=2927%20%E2%80%93%202936&rft.epage=2927%20%E2%80%93%202936&rft.au=KAMAR,%20Nassim&BERTRAND,%20Dominique&CAILLARD,%20Sophie&PIEVANI,%20Dani%C3%A8le&APITHY,%20Marie%20Joelle&rft.genre=article |
