Delisting of HLA antigens as a possible strategy to enable transplantation in highly sensitized patients with a cPRA ≥ 99.9.

Highly sensitized patients (especially those with a calculated Panel Reactive Antibody ≥ 99.9%) have little to no chances of having access to transplantation. Recently, delisting of human leukocyte antigens has been proposed as a possible strategy to enable transplantation in such patients. In this article, Cucchiari et al. describe the results of a prospective multicenter study based on a delisting strategy. Preliminary results suggest that such an approach has the potential to enable access to transplantation and increase the quality of life of many highly sensitized patients in terminal kidney failure.