ABSTRACT
Renal transplantation is clearly the optimal therapy for eligible patients with end-stage renal disease (ESRD).1 Unfortunately, due to the growing disparity between the number of patients waiting for renal transplantation and available organs, only a fraction of patients each year enjoy the benefits of transplantation. Patients who have become sensitized to human leukocyte antigen (HLA) molecules, whether this be due to previous transplants, blood transfusions or pregnancies, are disproportionately disadvantaged and comprise 30% of the patients on the waiting list in the USA.2 The situation is particularly desperate for the subgroup of highly sensitized (panel reactive antibody (PRA) >80%) patients who, on average, wait 6.7 years for a compatible organ or, indeed, never receive a transplant.2
