NEPHROLOGY – ORIGINAL PAPER Kidney transplantation after desensitization in sensitized patients: a Korean National Audit Kyu Ha Huh • Beom Seok Kim • Jaeseok Yang • Jeongmyung Ahn • Myung-Gyu Kim • Jae Berm Park • Jong Man Kim • Byung-Ha Chung • Joong Kyung Kim • Jin Min Kong Received: 12 January 2012 / Accepted: 26 March 2012 / Published online: 15 April 2012 Ó Springer Science+Business Media, B.V. 2012 Abstract Introduction The number of end-stage renal disease (ESRD) patients with preformed antibodies waiting for a kidney transplant has been increasing lately. We conducted a nationwide study on the outcomes of kidney transplantation after desensitization in Korea. Methods Six transplant centers have run desensiti- zation programs. The patients who underwent living donor kidney transplantation after desensitization from 2002 to 2010 were retrospectively analyzed. Results A total of 86 cases were enrolled. Thirty-five of these were cases of re-transplantation (40.7 %). Indications of desensitization were positive comple- ment-dependent cytotoxicity (CDC) cross-match responses (CDC ? , 36.0 %), positive flow-cytometric cross-match responses (FCX ? , 54.7 %), and positive donor-specific antibodies (DSA ? , 8.1 %). The desen- sitization protocols used pre-transplant plasmaphere- sis (95.3 %), intravenous immunoglobulin (62.8 %), and rituximab (67.4 %). Acute rejection occurred in 18 patients (20.9 %), graft failure occurred in 4 patients, and the 3-year graft survival rate was 93.8 %. The presence of DSA increased the acute Kyu Ha Huh and Beom Seok Kim equally contributed to this work. K. H. Huh Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea B. S. Kim Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea J. Yang (&) Á M.-G. Kim Transplantation Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 110-744 Seoul, Republic of Korea e-mail: jcyjs@dreamwiz.com J. Yang Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea J. Ahn Á J. M. Kong Department of Internal Medicine, Maryknoll Medical Center, Busan, Korea J. B. Park Department of Surgery, University of Ulsan College of Medicine, Seoul, South Korea J. M. Kim Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea B.-H. Chung Department of Internal Medicine, The Catholic University of Korea, Seoul, South Korea J. K. Kim Department of Medicine, Bong Seng Hospital, Busan, Korea 123 Int Urol Nephrol (2012) 44:1549–1557 DOI 10.1007/s11255-012-0169-1