GuidelineTransplant international : official journal of the European Society for Organ Transplantation2022
European Guideline for the Management of Kidney Transplant Patients With HLA Antibodies: By the European Society for Organ Transplantation Working Group.
Guideline in Transplant international : official journal of the European Society for Organ Transplantation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.
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Who cites it
45 citing papers in PubMed.
- 12-Month Outcomes of a Prospective Randomized Trial Investigating Effects of IVIG on Top of rATG Versus rATG Alone in Pre-Sensitized Kidney Transplant Recipients: The INHIBIT Study.Transplant international : official journal of the European Society for Organ Transplantation · 2025Trial
- Tailoring HLA antibody monitoring post-transplantation.Pediatric nephrology (Berlin, Germany) · 2026Article
- ISOT Position Statement on Immunological Evaluation in Kidney Transplantation.Clinical transplantation · 2026Article
- Article
- Novel Allocation Strategies Can Boost Kidney Exchange Programs: A Monte Carlo Simulation.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Long-term HLA-incompatible kidney transplant outcomes.Transplant international : official journal of the European Society for Organ Transplantation · 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
- Highly sensitized kidney transplant candidates: integrating acceptable mismatch, desensitization, imlifidase, and emerging immune-cell targeting strategies.Frontiers in immunology · 2026Review
- Landscape of current practices and future perspectives in living donor kidney donation in Europe: proceedings of a pan-European symposium by the European kidney transplant association section of the European Society for Organ Transplantation.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Retrospective cohort study of epitope-based virtual crossmatch allocation in a public transplant system (Pernambuco, Brazil).Frontiers in immunology · 2026Article
- Article
- Reshaping the landscape of HLA desensitization through immune engineering.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- 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
- Obinutuzumab in kidney transplantation: Past, present, and future.World journal of transplantation · 2025Review
- A novel allocation scheme for deceased donor kidneys to balance equity and utility.Kidney research and clinical practice · 2025Article
- Maximum cold ischemia duration for a kidney allograft: a prediction model for allograft failure at the time of organ allocation.EClinicalMedicine · 2025Article
- Expanding role of antibodies in kidney transplantation.World journal of transplantation · 2025Review
- Quality of Life of Donors After Living Kidney Transplantation: A Cross-Sectional Study.Life (Basel, Switzerland) · 2025Article
- Living Kidney Donation: A Narrative Review of Mid- and Long-term Psychosocial Outcomes.Transplantation · 2025Review
- Anti-Human Leukocyte Antigen Antibody Detection from Terasaki's Humoral Theory to Delisting Strategies in 2024.International journal of molecular sciences · 2025Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This guideline, from a European Society of Organ Transplantation (ESOT) working group, concerns the management of kidney transplant patients with HLA antibodies. Sensitization should be defined using a virtual parameter such as calculated Reaction Frequency (cRF), which assesses HLA antibodies derived from the actual organ donor population. Highly sensitized patients should be prioritized in kidney allocation schemes and linking allocation schemes may increase opportunities. The use of the ENGAGE 5 ((Bestard et al., Transpl Int, 2021, 34: 1005-1018) system and online calculators for assessing risk is recommended. The Eurotransplant Acceptable Mismatch program should be extended. If strategies for finding a compatible kidney are very unlikely to yield a transplant, desensitization may be considered and should be performed with plasma exchange or immunoadsorption, supplemented with IViG and/or anti-CD20 antibody. Newer therapies, such as imlifidase, may offer alternatives. Few studies compare HLA incompatible transplantation with remaining on the waiting list, and comparisons of morbidity or quality of life do not exist. Kidney paired exchange programs (KEP) should be more widely used and should include unspecified and deceased donors, as well as compatible living donor pairs. The use of a KEP is preferred to desensitization, but highly sensitized patients should not be left on a KEP list indefinitely if the option of a direct incompatible transplant exists.
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