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Transplantation
donor-specific HLA antibodies are performed at many centres without aspects, one possible approach would be to study and focus on the
any special desensitisation, although several studies show that a similarities between xenotransplantation and AB0i transplantation.
70,71
positive FACS cross-match is associated with a poor prognosis, New treatment protocols have recently made AB0i kidney transplantation
especially in the long term.
66,67
possible, and therefore similar protocols may also prove effective in the
xenogeneic setting.
The HLA barrier is seemingly more difficult to cross than the AB0 barrier,
and few centres report results equal to those of standard cross-match- Conclusion
negative transplantation. However, as the numbers of patients requiring Kidney transplantation provides the best survival and quality of life for
retransplantation are increasing, effective desensitisation protocols are patients with end-stage renal disease, the outcome having
certainly needed. dramatically improved after the introduction of cyclosporine. During
the past 10 years, a significant decrease in acute rejection rates has
Xenotransplantation been achieved. The general understanding of kidney transplantation
Many attempts at preclinical xenotransplantation have been performed has grown considerably, more than 22,000 scientific articles having
in non-human primate models, and the results have slowly and gradually been published.
72
improved. Recently, almost three months of renal xenograft survival has
been reported.
68
In addition, the risk of transmitting different Progress has also been made in areas such as immunosuppression and
endogenous retroviruses has been extensively studied.
69
However, in desensitisation, especially for AB0 incompatibility. However,
most of these animal studies, experimental, toxic and clinically not improvement in long-term graft survival has been limited during this
applicable immunosuppressive protocols have been applied. To develop period. In fact, this relative lack of success possibly constitutes the main
xenotransplantation into a realistic clinical alternative, the treatment challenge in kidney transplantation today. We need to concentrate our
protocols must be safe and effective in humans. Since the different efforts on improving long-term outcome in addition to preventing
immunological hurdles that need to be overcome share some important acute rejection. ■
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