{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T17:10:56Z","timestamp":1772039456260,"version":"3.50.1"},"reference-count":50,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T00:00:00Z","timestamp":1632441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Desensitization (DES) allows kidney transplantation for highly HLA-sensitized subjects. Due to the central role of IL-6 in the immunological response, tocilizumab may improve DES efficacy. Thus, we conducted a PubMed systematic review using the MeSH terms tocilizumab, interleukin-6, kidney transplantation, and desensitization. Tocilizumab (TCZ) was first studied for DES as the second-line treatment after failure of a standard DES protocol (SP) (apheresis, rituximab +\/\u2212 IVIg). Although TCZ (as a monotherapy) attenuated anti-HLA antibody rates, it did not permit transplantation. However, lymphocyte immuno-phenotyping has shown that TCZ hinders B-cell maturation and thus could improve the long-term efficacy of DES by limiting anti-HLA rebound and so avoid antibody-mediated rejection. This hypothesis is supported by a recent study where clazakizumab, a monoclonal antibody directed against IL-6, was continued after kidney transplantation in association with an SP. Nine out of ten patients were then eligible for transplantation, and there were no donor-specific antibodies at 6 months post-transplantation. In association with an SP, tocilizumab does not seem to significantly improve kidney-allograft access (short-term efficacy) vs. a SP only. However, it could improve the long-term prognosis of HLA-incompatible transplantation by hindering B-cell maturation and, thereby, avoiding donor-specific antibody rebounds post-transplantation.<\/jats:p>","DOI":"10.3390\/jcm10194359","type":"journal-article","created":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T20:15:32Z","timestamp":1632514532000},"page":"4359","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Tocilizumab and Desensitization in Kidney Transplant Candidates: Personal Experience and Literature Review"],"prefix":"10.3390","volume":"10","author":[{"given":"Jules","family":"Weinhard","sequence":"first","affiliation":[{"name":"Service de N\u00e9phrologie, H\u00e9modialyse, Aph\u00e9r\u00e8ses, et Transplantation R\u00e9nale, CHU Grenoble-Alpes, 38700 Grenoble, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2329-0392","authenticated-orcid":false,"given":"Johan","family":"Noble","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie, H\u00e9modialyse, Aph\u00e9r\u00e8ses, et Transplantation R\u00e9nale, CHU Grenoble-Alpes, 38700 Grenoble, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9016-7506","authenticated-orcid":false,"given":"Thomas","family":"Jouve","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie, H\u00e9modialyse, Aph\u00e9r\u00e8ses, et Transplantation R\u00e9nale, CHU Grenoble-Alpes, 38700 Grenoble, France"},{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 Grenoble-Alpes, 38700 Grenoble, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Malvezzi","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie, H\u00e9modialyse, Aph\u00e9r\u00e8ses, et Transplantation R\u00e9nale, CHU Grenoble-Alpes, 38700 Grenoble, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5130-7286","authenticated-orcid":false,"given":"Lionel","family":"Rostaing","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie, H\u00e9modialyse, Aph\u00e9r\u00e8ses, et Transplantation R\u00e9nale, CHU Grenoble-Alpes, 38700 Grenoble, France"},{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 Grenoble-Alpes, 38700 Grenoble, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1001\/jama.1993.03510110079036","article-title":"Comparison of Survival Probabilities for Dialysis Patients vs Cadaveric Renal Transplant Recipients","volume":"270","author":"Port","year":"1993","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1038\/ki.1996.307","article-title":"A study of the quality of life and cost-utility of renal transplantation","volume":"50","author":"Laupacis","year":"1996","journal-title":"Kidney Int."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Wong, G., Howard, K., Chapman, J.R., Chadban, S., Cross, N., Tong, A., Webster, A., and Craig, J. 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