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Blood transfusions, pregnancy, or organ transplantation can lead to development of antibodies against human leukocyte antigens (HLA) of non-self tissue. About a quarter of all patients who could benefit from kidney transplantation have antibodies against HLA of potential live donors. Because experience has shown that such patients are more vulnerable to graft rejection and failure, transplantation often is not attempted in them.
A team from Johns Hopkins tested a new approach in 211 consecutive patients with antibodies against HLA of potential grafts. Patients underwent plasmapheresis to lower the levels of such antibodies, received immune globulin with high levels of antibodies against cytomegalovirus, and received immunosuppressive agents,…