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Outcomes at 3 years...
Outcomes at 3 years posttransplant in imlifidase-desensitized kidney transplant patients
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Kjellman, Christian (author)
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Maldonado, Angela Q (author)
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Sjöholm, Kristoffer (author)
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Lonze, Bonnie E (author)
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Montgomery, Robert A (author)
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Runström, Anna (author)
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- Lorant, Tomas, 1975- (author)
- Uppsala universitet,Transplantationskirurgi
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Desai, Niraj M (author)
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Legendre, Christophe (author)
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Lundgren, Torbjörn (author)
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- von Zur-Mühlen, Bengt, Docent, 1966- (author)
- Uppsala universitet,Transplantationskirurgi
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Vo, Ashley A (author)
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Olsson, Håkan (author)
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Jordan, Stanley C (author)
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(creator_code:org_t)
- Elsevier, 2021
- 2021
- English.
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In: American Journal of Transplantation. - : Elsevier. - 1600-6135 .- 1600-6143. ; 21:12, s. 3907-3918
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Abstract
Subject headings
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- Imlifidase is a cysteine proteinase which specifically cleaves IgG, inhibiting Fc-mediated effector function within hours of administration. Imlifidase converts a positive crossmatch to a potential donor (T cell, B cell, or both), to negative, enabling transplantation to occur between previously HLA incompatible donor-recipient pairs. To date, 39 crossmatch positive patients received imlifidase prior to a kidney transplant in four single-arm, open-label, phase 2 studies. At 3 years, for patients who were AMR+ compared to AMR-, death-censored allograft survival was 93% vs 77%, patient survival was 85% vs 94%, and mean eGFR was 49 ml/min/1.73 m2 vs 61 ml/min/1.73 m2 , respectively. The incidence of AMR was 38% with most episodes occurring within the first month post-transplantation. Sub-analysis of patients deemed highly sensitized with cPRA ≥ 99.9%, and unlikely to be transplanted who received crossmatch-positive, deceased donor transplants had similar rates of patient survival, graft survival, and eGFR but a higher rate of AMR. These data demonstrate that outcomes and safety up to 3 years in recipients of imlifidase-enabled allografts is comparable to outcomes in other highly sensitized patients undergoing HLA-incompatible transplantation. Thus, imlifidase is a potent option to facilitate transplantation among patients who have a significant immunologic barrier to successful kidney transplantation.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- alloantibody
- clinical research/practice
- crossmatch
- desensitization
- immunosuppressant - other
- immunosuppression/immune modulation
- kidney transplantation/nephrology
- sensitization
Publication and Content Type
- ref (subject category)
- art (subject category)
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Kjellman, Christ ...
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Maldonado, Angel ...
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Sjöholm, Kristof ...
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Lonze, Bonnie E
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Montgomery, Robe ...
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Runström, Anna
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Lorant, Tomas, 1 ...
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Desai, Niraj M
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Legendre, Christ ...
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Lundgren, Torbjö ...
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von Zur-Mühlen, ...
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Vo, Ashley A
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Olsson, Håkan
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Jordan, Stanley ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Urology and Neph ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
- Articles in the publication
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American Journal ...
- By the university
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Uppsala University
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Karolinska Institutet