{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T18:02:33Z","timestamp":1781200953168,"version":"3.54.1"},"reference-count":146,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Despite development of kidney paired donation programs and prioritization in kidney allocation schemes, transplantation rates are still low and waiting times remain prolonged for highly sensitized kidney transplant recipients with broad human leukocyte antigen antibody reactivity. Desensitization confers an invaluable option improving access to kidney transplantation for sensitized patients who could not benefit from kidney paired donation programs and kidney allocation schemes. Conventional desensitization strategies use intravenous immunoglobulin combined with either plasmapheresis or monoclonal anti-CD20 antibodies. Imlifidase, IL-6 targeting agents, plasma cell-directed therapies, complement inhibitors, chimeric antigen receptor T-cell therapies, and B cell-activating factor inhibitors are emerging new options in the hope of enhancing and sustaining the efficacy of desensitization to improve allograft longevity. In this review, we discuss the rationale and outcome of desensitization with various strategies alone or in combination. Our aim is also to provide some insight for decision when pursuing desensitization might be successful or futile in sensitized patients.<\/jats:p>","DOI":"10.1093\/ckj\/sfaf219","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T15:21:18Z","timestamp":1752074478000},"source":"Crossref","is-referenced-by-count":2,"title":["Desensitization in HLA-incompatible kidney transplant recipients: current strategies and emerging perspectives"],"prefix":"10.1093","volume":"18","author":[{"given":"Mahmut","family":"Altindal","sequence":"first","affiliation":[{"name":"Section of Nephrology, Koc University School of Medicine Department of Medicine, , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Guldan","sequence":"additional","affiliation":[{"name":"Koc University School of Medicine Department of Medicine, , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lasin","family":"Ozbek","sequence":"additional","affiliation":[{"name":"Koc University School of Medicine Department of Medicine, , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sama Mahmoud","family":"Abdel-Rahman","sequence":"additional","affiliation":[{"name":"Koc University School of Medicine Department of Medicine, , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selen","family":"Unlu","sequence":"additional","affiliation":[{"name":"Koc University School of Medicine Department of Medicine, , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Murt","sequence":"additional","affiliation":[{"name":"Cerrahpasa Medical Faculty, Istanbul University\u2014Cerrahpasa Division of Nephrology, Department of Internal Medicine, , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2229-5140","authenticated-orcid":false,"given":"Nuri B","family":"Hasbal","sequence":"additional","affiliation":[{"name":"Section of Nephrology, Koc University School of Medicine Department of Medicine, , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulmecit","family":"Yildiz","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Faculty of Medicine, Bursa Uludag University , Nilufer, Bursa ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0577-7081","authenticated-orcid":false,"given":"Charles J","family":"Ferro","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham and Institute of Cardiovascular Sciences, University of Birmingham Department of Renal Medicine, , Birmingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Covic","sequence":"additional","affiliation":[{"name":"Nephrology Clinic, Dialysis and Renal Transplant Center, \u201cC.I. Parhon\u201d University Hospital , Iasi ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2521-8201","authenticated-orcid":false,"given":"Caner","family":"S\u00fcsal","sequence":"additional","affiliation":[{"name":"Transplant Immunology Research Center of Excellence TIREX, Ko\u00e7 University , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1297-0675","authenticated-orcid":false,"given":"Mehmet","family":"Kanbay","sequence":"additional","affiliation":[{"name":"Section of Nephrology, Koc University School of Medicine Department of Medicine, , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"2025080109070295200_bib1","doi-asserted-by":"publisher","first-page":"684","DOI":"10.2215\/CJN.05930615","article-title":"Approach to 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