The alloimmunized patient: Monitoring and therapeutics

The sensitization of renal transplant patients in the form of antihuman leukocyte antigen antibodies often constitutes significant risk to allograft function. Testing for these antibodies is done before, at the time of, and after renal transplantation. Correct underpretation of the results necessitates an understanding of the principles of the tests and of the clinical factors in the patients, especially those receiving another transplant. Treatment remains difficult, although preliminary trials with intravenous gamma globulin have shown promising results in some patients.