What are desensitization protocols?
Desensitization for the highly sensitized patients involves decreasing preformed antibody levels. This occurs prior to induction. There are several different methods that include various medications, including rituximab, bortezomib, intravenous immunoglobulin, plasmapheresis, and early initiation of maintenance immunosuppression weeks before transplantation. The outcomes have been equivocal. In addition, there is a significant financial cost as well as increased malignancy and infectious risk for the patient.