Tolerance and cytokine profiles in sensitized transplant recipients.

The immediate and fulminant rejection of human renal allografts in sensitized recipients was first described more than 30 years ago [1]. The process of hyperacute rejection, occurring within minutes or hours after revascularization, is thought to be primarily mediated by pre-existing anti-donor antibodies (Abs) [2]. That it has become rare in recent years is primarily ascribed to improved crossmatching techniques [3]. However, at present, over 20% of patients with end-stage renal disease on waiting transplant lists are considered highly sensitized. Apart from prior failed allografts, this may result from blood transfusions or pregnancies. These highly sensitized patients experience an increased rate of graft rejection, compared to unsensitized individuals, which is often irreversible and unresponsive to currently used immunosuppressive therapy. [ABSTRACT FROM AUTHOR]