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Transplantology
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Strategies for Access to Kidney Transplantation for Highly Sensitized and...
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Strategies for Access to Kidney Transplantation for Highly Sensitized and Incompatible Patients

A special issue of Transplantology (ISSN 2673-3943).

Deadline for manuscript submissions: 31 December 2024 | Viewed by 6813

Special Issue Editor

Prof. Dr. Maurizio Salvadori

E-Mail Website
Guest Editor
Department of Transplantation—Renal Unit, Careggi University Hospital, 50139 Florence, Italy
Interests: immunology; renal transplantation; epidemiology; coronavirus infection; organ transplantation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Historically, the lack of adequate strategies and powerful immunosuppressants make it impossible or an unacceptable risk level for kidney transplant in highly immunized patients or in the case of AB0 incompatible pairs. The aim of this Special Issue is to describe new strategies and new drugs that allow for such high-risk transplantation. Several trials are, to date, ongoing and should be described in detail. We are soliciting papers describing these new drugs as well as new strategies. Strategies related to the Exchange Programmes (KEP) should also be the object of some papers. In particular, KEP allows transplantation between AB0 incompatible pairs.

Prof. Dr. Maurizio Salvadori
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Transplantology is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • desensitization
  • sensitized patients
  • kidney transplantation
  • AB0 incompatible patients
  • kidney exchange programmes

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Published Papers (3 papers)

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Editorial

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5 pages, 753 KiB  
Editorial
Strategies for Access to Kidney Transplantation for Highly Sensitized and Incompatible Patients
by Maurizio Salvadori
Transplantology 2023, 4(2), 85-89; https://doi.org/10.3390/transplantology4020009 - 22 May 2023
Cited by 2 | Viewed by 1932
Abstract
One of the major challenges in developing programs for kidney transplantation is represented by the presence of antibodies targeting the HLA of the donor in the recipients and, in particular cases, the incompatibility of the ABO blood groups among donor and recipient for [...] Read more.
One of the major challenges in developing programs for kidney transplantation is represented by the presence of antibodies targeting the HLA of the donor in the recipients and, in particular cases, the incompatibility of the ABO blood groups among donor and recipient for living donors [...] Full article
(This article belongs to the Special Issue Strategies for Access to Kidney Transplantation for Highly Sensitized and Incompatible Patients)
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Review

Jump to: Editorial, Other

12 pages, 521 KiB  
Review
Update on Desensitization Strategies and Drugs on Hyperimmune Patients for Kidney Transplantation
by Maurizio Salvadori
Transplantology 2023, 4(3), 139-150; https://doi.org/10.3390/transplantology4030014 - 8 Aug 2023
Cited by 2 | Viewed by 3392
Abstract
The presence in a recipient of antibodies directed against donor-specific antigens represents a major obstacle to transplantation. Removal of these antibodies represents a challenge for physicians dealing with kidney transplantation. Several strategies, techniques, and old and new drugs are currently used for desensitizing [...] Read more.
The presence in a recipient of antibodies directed against donor-specific antigens represents a major obstacle to transplantation. Removal of these antibodies represents a challenge for physicians dealing with kidney transplantation. Several strategies, techniques, and old and new drugs are currently used for desensitizing these patients. Desensitization may either occur before transplantation, at the time of transplantation, or after transplantation according to whether physicians are dealing with living or deceased donors. Different techniques may be used to reveal the presence of antibodies in the recipients; each technique has different sensitivities and specificities, and different advantages and drawbacks. The targets of the drugs used to desensitize are B cells, plasma cells, the antibodies themselves, and, finally, the complement that is the final actor causing tissue disruption. B cells are relatively easy to target; targeting the plasma cell is more difficult. Indeed, several new drugs are also used in randomized trials to defeat plasma cells. Antibodies may be removed easily, but their removal is often followed by antibody rebound. The complement is not easy to defeat and new drugs are currently used for this aim. Overall, despite difficulties, desensitization is currently possible in many cases, to obtain a safe and successful transplantation. Full article
(This article belongs to the Special Issue Strategies for Access to Kidney Transplantation for Highly Sensitized and Incompatible Patients)
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Other

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15 pages, 1436 KiB  
Perspective
The Impact of Alloantibodies on Clinical VCA Outcomes and the Need for Immune Tolerance
by Caitlin M. Blades, Nalu Navarro-Alvarez, Christene A. Huang and David W. Mathes
Transplantology 2024, 5(3), 148-162; https://doi.org/10.3390/transplantology5030015 - 29 Jul 2024
Viewed by 761
Abstract
The functional outcomes and restoration of form after vascularized composite allotransplantation (VCA) have exceeded the results that could be achieved with current autologous surgical techniques. However, the longevity of VCA grafts has been limited due to the development of donor-specific antibodies (DSAs), and [...] Read more.
The functional outcomes and restoration of form after vascularized composite allotransplantation (VCA) have exceeded the results that could be achieved with current autologous surgical techniques. However, the longevity of VCA grafts has been limited due to the development of donor-specific antibodies (DSAs), and chronic rejection and graft failure occur despite long-term immunotherapy. Furthermore, despite widespread consensus that these non-life-saving transplants are beneficial for select patients, the application of VCA is limited by the need for lifelong immunosuppression. Therefore, attempts to achieve drug-free tolerance through safe and effective therapies are critical. This review highlights recent publications regarding alloantibody-mediated rejection (AMR) in various VCAs with a focus on the critical need for novel tolerance-inducing strategies. The development and implementation of effective methods of inducing tolerance, such as the use of anti-CD3 immunotoxins, could drastically improve VCA graft outcomes and recipient quality of life. Full article
(This article belongs to the Special Issue Strategies for Access to Kidney Transplantation for Highly Sensitized and Incompatible Patients)
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