ReviewFrontiers in immunology2021
Highly Sensitized Patients Are Well Served by Receiving a Compatible Organ Offer Based on Acceptable Mismatches.
Review in Frontiers in immunology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 50 citations in OpenAlex.
- Sensitization and Deceased-Donor Kidney Transplant Access in France.Kidney international reports · 2026Article
- Highly sensitized kidney transplant candidates: integrating acceptable mismatch, desensitization, imlifidase, and emerging immune-cell targeting strategies.Frontiers in immunology · 2026Review
- Risk-adapted HLA delisting and imlifidase-enabled deceased-donor kidney transplantation in highly sensitized kidney transplant candidates: a German expert consensus report.Frontiers in immunology · 2026Article
- Retrospective cohort study of epitope-based virtual crossmatch allocation in a public transplant system (Pernambuco, Brazil).Frontiers in immunology · 2026Article
- Improved access to kidney transplantation with favorable graft survival in highly sensitized candidates under the French acceptable mismatch program.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Novel Allocation Strategies Can Boost Kidney Exchange Programs: A Monte Carlo Simulation.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Desensitization in HLA-incompatible kidney transplant recipients: current strategies and emerging perspectives.Clinical kidney journal · 2025Review
- Article
- Development of the Crossmatch Test in Kidney Transplantation Up to the Virtual Level.Journal of clinical medicine · 2025Review
- Anti-Human Leukocyte Antigen Antibody Detection from Terasaki's Humoral Theory to Delisting Strategies in 2024.International journal of molecular sciences · 2025Review
- Kidney transplant outcomes in HLA desensitized patients with pretransplant CDC and/or FCM positive crossmatches.Frontiers in immunology · 2025Article
- Comprehensive Characterization of Anti-HLA and Non-HLA Antibodies in Patients on Kidney Transplant Waiting List and Evaluation of Their Impact on Alloimmunization Risk and Dialysis Treatment.International journal of molecular sciences · 2024Article
- Positive Long-Term Outcome of Kidney Allocation via Acceptable Mismatch Program in Highly Sensitized Patients.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2024Article
- Old for young kidney transplantation: a responsible option for our patients to reduce waiting time?World journal of urology · 2024Article
- Proficiency testing within Eurotransplant.Frontiers in genetics · 2024Article
- Improving long-term kidney allograft survival by rethinking HLA compatibility: from molecular matching to non-HLA genes.Frontiers in genetics · 2024Review
- Assessment of access and outcomes of kidney transplantation through the reforms of the Swiss organ allocation system.Frontiers in public health · 2024Article
- Sex and Gender Disparities in Living Kidney Donation: A Scoping Review.Transplantation direct · 2023Article
- Increasing Kidney-Exchange Options Within the Existing Living Donor Pool With CIAT: A Pilot Implementation Study.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
- Imlifidase for Kidney Transplantation of Highly Sensitized Patients With a Positive Crossmatch: The French Consensus Guidelines.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Highly sensitized kidney patients accrue on the transplant waiting list due to their broad immunization against non-self Human Leucocyte Antigens (HLA). Although challenging, the best option for highly sensitized patients is transplantation with a crossmatch negative donor without any additional therapeutic intervention. The Eurotransplant Acceptable Mismatch (AM) program was initiated more than 30 years ago with the intention to increase the chance for highly sensitized patients to be transplanted with such a compatible donor. The AM program allows for enhanced transplantation to this difficult to transplant patient group by allocating deceased donor kidneys on the basis of a match with the recipient's own HLA antigens in combination with predefined acceptable antigens. Acceptable antigens are those HLA antigens towards which the patients has never formed antibodies, as determined by extensive laboratory testing. By using this extended HLA phenotype for allocation and giving priority whenever a compatible donor organ becomes available, organ offers are made for roughly 80% of patients in this program. Up till now, more than 1700 highly sensitized patients have been transplanted through the AM program. Recent studies have shown that the concept of acceptable mismatches being truly immunologically acceptable holds true for both rejection rates and long-term graft survival. Patients that were transplanted through the AM program had a similar rejection incidence and long-term graft survival rates identical to non-sensitized patients transplanted through regular allocation. However, a subset of patients included in the AM program does not receive an organ offer within a reasonable time frame. As these are often patients with a rare HLA phenotype in comparison to the Eurotransplant donor population, extension of the donor pool for these specific patients through further European collaboration would significantly increase their chances of being transplanted. For those patients that will not benefit from such strategy, desensitization is the ultimate solution.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.