Nephrolog

What is a “sensitized” potential recipient?
A “sensitized” potential recipient is an individual that has detectable preformed HLA antibodies
that pose considerable future risk to the allograft survival. Patient sensitization is classically
reported as the percent panel reactivity antibody (PRA). PRA is defined as the percentage of
donors expected to react with a patient’s serum based on known antibody activities (i.e., the
patient’s degree of sensitization). Approximately 17% of the patients currently on the deceased
donor waiting list are highly presensitized (defined as .80% percent panel reactivity). Highly
“sensitized” patients often cross-match positive to multiple potential donors and require a zero
antigen mismatch allograft to increase success. Consequently, these “sensitized” patients are
less likely to be transplanted or will spend an extended time on the wait-list pending the
availability of a suitable donor

What are some ways that potential recipients become sensitized?
n Pregnancy
n Exposure to antigens from previous transplants
n Exposure to antigens from blood product exposure (e.g., transfusions)

. What are some methods to desensitize potential recipients who possess
preformed HLA antibodies?
n Intravenous immunoglobulin
n Plasmapheresis
n Rituximab
n Splenectomy