ArticleTransplant international : official journal of the European Society for Organ Transplantation2024
European Consensus on the Management of Sensitized Kidney Transplant Recipients: A Delphi Study.
Article in Transplant international : official journal of the European Society for Organ Transplantation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 9 citations in OpenAlex.
- Risk Phenotyping Before Graft Implantation: FTIR Spectroscopy and Machine Learning for Complementary Risk Stratification in Kidney Transplantation.Medical sciences (Basel, Switzerland) · 2026Article
- Rejection-Focused Precision Medicine in Kidney Transplantation: Biology, Biomarkers, and Artificial Intelligence.Life (Basel, Switzerland) · 2026Review
- 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
- Safety and efficacy of rituximab-free ABO incompatible kidney transplantation: a German multicenter cohort study.Frontiers in nephrology · 2026Article
- Development and clinical implementation of a local automated kidney allocation platform integrating virtual crossmatch.Frontiers in immunology · 2026Article
- Human leukocyte antigen-incompatible living donor kidney transplantation after desensitization: experience from a major transplant centre in Mexico.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Article
- Inefficiency Rates of Biological Immunosuppressive Induction Agents Used in Organ Transplantation: A Pharmacovigilance Study.Journal of clinical medicine · 2025Article
- Development of the Crossmatch Test in Kidney Transplantation Up to the Virtual Level.Journal of clinical medicine · 2025Review
- Article
- Impact of induction agents and maintenance immunosuppression on torque teno virus loads and year-one complications after kidney transplantation.Frontiers in immunology · 2024Article
- Desensitization With Imlifidase for HLA-Incompatible Deceased Donor Kidney Transplantation: A Delphi International Expert Consensus.Transplant international : official journal of the European Society for Organ Transplantation · 2024Article
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
An increasing number of sensitized patients awaiting transplantation face limited options, leading to fatalities during dialysis and higher costs. The absence of established evidence highlights the need for collaborative consensus. Donor-specific antibodies (DSA)-triggered antibody-mediated rejection (AMR) significantly contributes to kidney graft failure, especially in sensitized patients. The European Society for Organ Transplantation (ESOT) launched the ENGAGE initiative, categorizing sensitized candidates by AMR risk to improve patient care. A systematic review assessed induction and maintenance regimens as well as antibody removal strategies, with statements subjected to the Delphi methodology. A Likert-scale survey was distributed to 53 European experts (Nephrologists, Transplant surgeons and Immunologists) with experience in kidney transplant recipient care. A rate ≥75% with the same answer was considered consensus. Consensus was achieved in 95.3% of statements. While most recommendations aligned, two statements related to complement inhibitors for AMR prophylaxis lacked consensus. The ENGAGE consensus presents contemporary recommendations for desensitization and immunomodulation strategies, grounded in predefined risk categories. The adoption of tailored, patient-specific measures is anticipated to streamline the care of sensitized recipients undergoing renal allografts. While this approach holds the promise of enhancing transplant accessibility and fostering long-term success in transplantation outcomes, its efficacy will need to be assessed through dedicated studies.
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