Introduction
chronic kidney disease, ESKD
KIDNEY, END STAGE KIDNEY DISEASE, SENSITIZATION
Kidney transplantation (KT) is universally acknowledged to be the treatment of choice for patients with end stage kidney disease (ESKD) in terms of survival and quality of life. In France, as elsewhere, the population affected by chronic kidney disease has grown steadily over the past decades totaling 51,000 patients with ESKD on dialysis and 9,675 on KT waiting lists in December 2021, whilst deceased donor organ procurement has plateaued, resulting in a shortage of organs [Sensitization against HLA epitopes through blood transfusion, pregnancy and prior organ transplantation also hampers KT access resulting in protracted waiting time and increased mortality. Within the Eurogroup Transplantation Consortium it is thus estimated that 5% of patients are deemed highly sensitized (HS), as determined by an HLA antibody profile that reacts to ≥85%–100% of donors in the donor population [Desensitization protocols have emerged as one approach to overcome the HLA barrier and allow for KT in HS ESKD patients [