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Research Article Volume 14 Issue 1
Kidney transplantation after desensitization in hypersensitized recipients a single-center case series from an annual cohort of 50 transplants (2025)
Ehtuish Ehtuish,  , Reiad Elmugrbi, Abdulrazak Bakeer,  , Isam Saeed,  , Munir Aboudhair, Saleh Husaik, Riham Sadik,  , Entisar Naily,  , Usama Dernawi,  , Entisar Mareei
Received: March 18, 2026 | Published: April 28, 2026
Citation: Ehtuish E, Elmugrbi R, Bakeer A, et al. Kidney transplantatsion after desensitization in hypersensitized recipients a single-center case series from an annual cohort of 50 transplants (2025). Urol Nephrol Open Access J. 2026;14(1):27-29. DOI: 10.15406/unoaj.2026.14.00368
Abstract
Background: Hypersensitization remains a major barrier to kidney transplantation due to elevated panel reactive antibodies (PRA), donor-specific antibodies (DSA), and high mean fluorescence intensity (MFI), all of which are associated with increased risks of antibodymediated rejection and early graft dysfunction.1–4 Methods: This retrospective single-center case series includes hypersensitized kidney transplant recipients treated in 2025. Among 50 kidney transplants performed during the study year, six recipients (12%) fulfilled immunological criteria for hypersensitization and underwent tailored desensitization protocols. Sensitization profiles, desensitization strategies, and early post-transplant outcomes were analyzed descriptively. Results: All recipients demonstrated positive peak PRA (Class I only: 50%; Class I and II: 50%). DSA burden varied, including one case with MFI >6000. Desensitization included double filtration plasmapheresis (DFPP), intravenous immunoglobulin (IVIG) in 83.3%, rituximab in 33.3%, and rATG induction in 66.7%. All CDC cross-matches were negative at transplantation. Delayed graft function occurred in 33.3%, acute rejection in 16.7%, and no early infectious complications were recorded. Renal function improved in all patients by postoperative day 7. Conclusions: Individualized desensitization enabled successful kidney transplantation in hypersensitized recipients with acceptable early outcomes, supporting its role as a viable strategy when alternative allocation pathways are limited.1,2,5
Keywords: organ donation, transplantation ethics public attitudes, Libya, islamic bioethics
©2026 Ehtuish, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.