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Purpose of Review <p>This review examines allosensitization in islet transplant recipients, its impact on kidney transplant outcomes, and advances in therapies to prevent allosensitization and strategies for desensitization.</p> Recent Findings <p>Allosensitization results from donor-specific antibodies (DSAs) triggered by HLA mismatches, inflammation, and repeated transplants. Innovations such as anti-CD25 antibodies, regulatory T-cell therapies, and proteasome inhibitors reduce immune activation while preserving graft function. Desensitization approaches, including rituximab and plasmapheresis, show promise in lowering DSAs. Prolonged islet culture may further minimize immunogenicity by reducing antigenicity. National paired exchange programs improve access to renal transplantation for highly sensitized patients.</p> Summary <p>Allosensitization remains a challenge for sensitized islet transplant recipients needing kidney transplants. Emerging therapies and desensitization protocols improve outcomes by improving graft survival. Future research should validate these strategies and refine frameworks for better graft survival and organ allocation.</p>

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Risk of Allosensitization for Islet Recipients and Impact on Access To Renal Transplant

  • 期刊论文

  • 发表日期：

    2025年7月30日

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  • Zofia Czarnecka,
  • A. M. James Shapiro

摘要

Purpose of Review

This review examines allosensitization in islet transplant recipients, its impact on kidney transplant outcomes, and advances in therapies to prevent allosensitization and strategies for desensitization.

Recent Findings

Allosensitization results from donor-specific antibodies (DSAs) triggered by HLA mismatches, inflammation, and repeated transplants. Innovations such as anti-CD25 antibodies, regulatory T-cell therapies, and proteasome inhibitors reduce immune activation while preserving graft function. Desensitization approaches, including rituximab and plasmapheresis, show promise in lowering DSAs. Prolonged islet culture may further minimize immunogenicity by reducing antigenicity. National paired exchange programs improve access to renal transplantation for highly sensitized patients.

Summary

Allosensitization remains a challenge for sensitized islet transplant recipients needing kidney transplants. Emerging therapies and desensitization protocols improve outcomes by improving graft survival. Future research should validate these strategies and refine frameworks for better graft survival and organ allocation.