Desensitization Protocol for Highly Sensitized Patients on the Waiting List for Kidney Transplant

Phase 2 Study of Desensitization Protocol for Highly Sensitized Wait Listed Patients

The purpose of this study is to determine whether high dose IVIG and B cell depleting agents can be used effectively in highly sensitized wait-listed patients.

HLA sensitization is known to be the most important barrier to deceased donor kidney allocation. Therefore, the investigators need to develop better strategies for managing pre-sensitized patients using desensitization protocol. In this study the investigators will used two kinds of medication for the reduction of circulating antibodies (high dose IVIg, B cell depleting agents) to highly-sensitized patients who are on the waiting list for a deceased donor kidney transplantation. After desensitization, the investigators will check that this treatment can increase their chances of receiving a kidney transplant.

Inclusion Criteria:

• Age ≥ 18
• patients who are on the waiting list more than 4 years
• PRA I or II > 50%

Exclusion Criteria:

• Recent recipients of any live attenuated vaccine(s) within 4 weeks
• Subjects who have received IVIG or B cell depleting agents previously
• Subjects with positive result for viral hepatitis(B,C) or HIV infection
• Subjects with active infection
• Lactating or pregnant females
• Subjects who have history of malignancy in recent 5years
• Subjects who have experience of treatment for the psychiatric problem in recent 6months
• Subjects who have hematologic abnormality (Hb < 7g/dL, Platelet < 100,000/mm3, AST/ALT > 80IU)