2026-04-13T06:43:57Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/114022025-10-24T10:36:56Zcom_2072_378070com_2072_378040col_2072_378092

00925njm 22002777a 4500 dc FURIAN, LUCREZIA author Cozzi, Emanuele author Diekmann, Fritz author mamode, nizam author Bestard, Oriol author Budde, Klemens author 2024-05-03T10:29:22Z 2024-05-03T10:29:22Z 2024-04-11 Delphi; Immunomodulation; Kidney transplantation Delfos; Immunomodulació; Trasplantament de ronyó Delfos; Inmunomodulación; Trasplante de riñón An increasing number of sensitized patients awaiting transplantation face limited options, leading to fatalities during dialysis and higher costs. The absence of established evidence highlights the need for collaborative consensus. Donor-specific antibodies (DSA)-triggered antibody-mediated rejection (AMR) significantly contributes to kidney graft failure, especially in sensitized patients. The European Society for Organ Transplantation (ESOT) launched the ENGAGE initiative, categorizing sensitized candidates by AMR risk to improve patient care. A systematic review assessed induction and maintenance regimens as well as antibody removal strategies, with statements subjected to the Delphi methodology. A Likert-scale survey was distributed to 53 European experts (Nephrologists, Transplant surgeons and Immunologists) with experience in kidney transplant recipient care. A rate ≥75% with the same answer was considered consensus. Consensus was achieved in 95.3% of statements. While most recommendations aligned, two statements related to complement inhibitors for AMR prophylaxis lacked consensus. The ENGAGE consensus presents contemporary recommendations for desensitization and immunomodulation strategies, grounded in predefined risk categories. The adoption of tailored, patient-specific measures is anticipated to streamline the care of sensitized recipients undergoing renal allografts. While this approach holds the promise of enhancing transplant accessibility and fostering long-term success in transplantation outcomes, its efficacy will need to be assessed through dedicated studies. This work was supported by The European Society for Organ Transplantation (ESOT), Westerdoksdijk 423, 1013 BX Amsterdam, Netherlands, including all publication fees, with the unconditional support of CHIESI Farmaceutici S.p.A. and Hansa Biopharma. The funders were not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication. The medical writer for this manuscript was also supported by ESOT. The authors maintained complete control over the manuscript content, and it reflects their opinions. http://hdl.handle.net/11351/11402 Decisió de grup Ronyons - Trasplantació Immunoglobulines Empelt contra l'hoste, Malaltia de l' PSYCHIATRY AND PSYCHOLOGY::Behavior and Behavior Mechanisms::Psychology, Social::Group Processes::Consensus PHENOMENA AND PROCESSES::Immune System Phenomena::Transplantation Immunology::Host vs Graft Reaction::Graft Rejection ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Renal Replacement Therapy::Kidney Transplantation CHEMICALS AND DRUGS::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Isoantibodies PSIQUIATRÍA Y PSICOLOGÍA::conducta y mecanismos de la conducta::psicología social::procesos de grupo::consenso FENÓMENOS Y PROCESOS::fenómenos del sistema inmunitario::inmunología del trasplante::reacción huésped contra injerto::rechazo del injerto TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::tratamiento de reemplazo renal::trasplante de riñón COMPUESTOS QUÍMICOS Y DROGAS::aminoácidos, péptidos y proteínas::proteínas::proteínas sanguíneas::inmunoproteínas::inmunoglobulinas::anticuerpos::isoanticuerpos European Consensus on the Management of Sensitized Kidney Transplant Recipients: A Delphi Study