Calcineurin inhibitor-free monotherapy in human leukocyte antigen–identical live donor renal transplantation.

Background: Most recent trials in human leukocyte antigen (HLA)-identical living donor (LD) renal transplantation have used immunosuppressive regimens with no induction therapy, corticosteroid-free long-term treatment, and calcineurin inhibitor minimization.

Patients And Methods: Seven HLA-identical LD recipients were prospectively enrolled. Immunosuppression included induction therapy with antithymocyte globulins for 10 days and long-term monotherapy with mycophenolate mofetil (2 g/day) in six cases and sirolimus (target trough levels: 6-10 ng/mL) in the last case.

Vaccination in adults with auto-immune disease and/or drug related immune deficiency: results of the GEVACCIM Delphi survey.

Introduction: There are insufficient data regarding the efficacy and safety of vaccination in patients with auto-immune disease (AID) and/or drug-related immune deficiency (DRID). The objective of this study was to obtain professional agreement on vaccine practices in these patients.

Methods: A Delphi survey was carried out with physicians recognised for their expertise in vaccinology and/or the caring for adult patients with AID and/or DRID.

Antidonor antibodies and transplantation: how to deal with them before and after transplantation.

The presence of antibodies directed against the donor has usually been considered as an absolute contraindication to transplantation. However, recent advances both in the ABO and human leukocyte antigen settings, detailed in this paper, have led to successful transplantations in the presence of antidonor antibodies, with preliminary evidence of accommodation.

Intravenous immunoglobulins and transplantation for patients with anti-HLA antibodies.

Transplantation for patients possessing allo-antibodies against HLA antigens can be delayed for years, and, once the graft has been transplanted, its survival is significantly reduced. We and others have shown that administration of intravenous immunoglobulins (IVIgs) can induce a profound and sustained decrease in the titres of the anti-HLA antibodies, thus greatly enhancing the chances of those patients to obtain a transplant. In a number of cases, pre-treatment sera contained anti-donor antibodies that disappeared after IVIg administration.

Desensitization and subsequent kidney transplantation of patients using intravenous immunoglobulins (IVIg).

Transplantation of patients possessing antibodies against allo-HLA antigens can be delayed for years. We have shown that administration of intravenous immunoglobulins (IVIg) can induce a profound and sustained decrease in the titers of anti-HLA antibodies. We report here the first series of patients desensitized, then transplanted using IVIg therapy.