This retrospective observation study was performed in order to uncover the current status of desensitization therapy in renal transplantation recipients with donor-specific antibodies using intravenous immunoglobulin in Japan.
A primary survey was conducted at facilities that carried out renal transplantation from 2014 to 2016. From the survey it was revealed that desensitization therapy is based on the combination of multiple drugs and therapies, and in particular rituximab, plasma exchange, and mycophenolate mofetil were found to be frequently used. In addition, it was found that there is a demand for the use of intravenous immunoglobulin as part of the combination therapy in order to achieve more successful desensitization.
Subsequently, a secondary survey was performed regarding desensitization cases that used intravenous immunoglobulin from 2014 to 2016. In the cases where living-donor renal transplant was performed after desensitization therapy, rejection occurred in 40% of cases, but the graft survival rate at 2 years after transplantation was estimated to be 100%. This result was considered satisfactory regarding renal transplantation in recipients with donor-specific antibodies.