Polyclonal and monoclonal antibodies in renal transplant: An update

Amna Ilahe, Pooja Budhiraja, B. Kaplan

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose of review There are several monoclonal and polyclonal antibodies used in renal transplantation today, this article will discuss several agents, their updates and newer agents. Recent findings Antithymocyte globulin and interleukin-2 (IL-2) receptor blocker continue to be used as induction agents. The risk of acute rejection was higher in IL-2 receptor blockers mainly in the first year, but graft survivals were similar in both groups long term. Belatacept is the only approved intravenous maintenance immunosuppressive therapy which provides the benefit of glomerular filtration rate preservation, but it was associated with a higher risk of acute rejection and post-transplant lymphoproliferative disorder. Bortezomib may help decrease donor-specific antibody levels, but there are limited data to support its use for desensitization or rejection. Eculizumab may help in antibody-mediated rejection in some cases but has not shown promising long-term effects in high-risk individuals. Newer agents have been continuously tested for improved efficacy and safety. Summary Transplantation is the standard of care for end-stage renal disease patients, but we still have a long way to go, as we need to improve long-term outcomes. The manipulation of the immune system is a delicate undertaking, with risks of adverse events; therefore, risk versus benefit needs to be carefully evaluated and treatment needs to be individualized.

Original languageEnglish (US)
Pages (from-to)563-569
Number of pages7
JournalCurrent Opinion in Nephrology and Hypertension
Volume24
Issue number6
DOIs
StatePublished - Oct 9 2015
Externally publishedYes

Fingerprint

Monoclonal Antibodies
Transplants
Kidney
Interleukin-2 Receptors
Antilymphocyte Serum
Lymphoproliferative Disorders
Antibodies
Graft Rejection
Graft Survival
Standard of Care
Immunosuppressive Agents
Glomerular Filtration Rate
Kidney Transplantation
Chronic Kidney Failure
Immune System
Transplantation
Maintenance
Tissue Donors
Safety
Therapeutics

Keywords

  • Antibodies
  • Biologics
  • Monoclonal
  • Newer agents
  • Polyclonal
  • Renal transplant

ASJC Scopus subject areas

  • Nephrology
  • Internal Medicine

Cite this

Polyclonal and monoclonal antibodies in renal transplant : An update. / Ilahe, Amna; Budhiraja, Pooja; Kaplan, B.

In: Current Opinion in Nephrology and Hypertension, Vol. 24, No. 6, 09.10.2015, p. 563-569.

Research output: Contribution to journalArticle

Ilahe, Amna ; Budhiraja, Pooja ; Kaplan, B. / Polyclonal and monoclonal antibodies in renal transplant : An update. In: Current Opinion in Nephrology and Hypertension. 2015 ; Vol. 24, No. 6. pp. 563-569.
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