We report our experience with desensitization and the renal transplant outcome in nine highly sensitized individuals with positive T & B cross-match (XM) (group I) and in three individuals with positive T XM (group II). All Transplants were from living donors. Desensitization protocol for group I consisted of: (1) pre-transplant protein A immunoadsorption (IA), and intravenous immunoglobulin (IVIG); (2) peri-transplant induction with Thymoglobulin® and Rituximab®; (3) post-transplant quadruple therapy with Tacrolimus, Rapamycin, Mycophenolate Mofitil and Prednisone. Desensitization protocol for group II was similar to group I without IA or Rituximab®. All but three patients in group I were successfully desensitized and received kidneys from their historically positive XM living donors.

	Age	FU	Cr	AMR*ordf	SCR**	PB***
	Yr	mos	µmol/L
GI (N=6)	42 (33-56)	12.5 (4-18)	103 (55-138)	1 (5/6)	0	NL
GII (N=3)	51 (42-56)	5(3-8)	102 (83-137)	1 (2/3)	0	NL

AMR *: Antibody-mediated rejection, **: subclinical rejection PB***: protocol biopsy at three and six months for group II and I respectively

Desensitization and subsequent living donor kidney transplantation can be performed successfully in highly sensitized positive T & B XM recipients after desensitization according to the above protocols. Renal allograft functional and histological parameters at three and six months suggest that these grafts are likely to have an excellent long-term prognosis.