Published online Jan 27, 2016. doi: 10.4240/wjgs.v8.i1.101
Peer-review started: May 23, 2015
First decision: August 14, 2015
Revised: August 18, 2015
Accepted: September 10, 2015
Article in press: September 16, 2015
Published online: January 27, 2016
Sensitized patients tend to have longer waiting times on the deceased donor list and are at increased risk of graft loss from acute or chronic rejection compared to non-sensitized candidates. Desensitization protocols are utilized to decrease the levels of alloantibodies and to convert an initial positive cross-match to prospective donors into a negative crossmatch. These procedures are mostly available in the setting of living donation. Due to the elective nature of the procedure, desensitization protocols can be extended until the desire result is obtained prior to transplantation. We present two cases of successful desensitization protocol applied to living donor intestinal transplant candidates that converted to negative cross-match to their donors. We present two cases of intestinal transplant candidates with a potential living donor to whom they are sensitized. Both cases underwent successful transplantation after desensitization protocol. No evidence of humoral rejection has occurred in either recipient. Living donor intestinal transplantation in sensitized recipients against the prospective donors provides the ability to implement a desensitization protocol to convert to negative cross-match.
Core tip: Intestinal transplant candidates are frequently sensitized and waiting longer on the list. Living donation of intestine has been successful and allows for time to immunologically prepare sensitized recipient prior to transplant to achieve higher degree of success.