Transplantation in sensitized patients
Patients with advanced chronic kidney disease require renal replacement therapies, and kidney transplantation is the most effective and beneficial option. However, there is a group of sensitized patients who are less likely to access a kidney transplant, either because they have had previous transplants, transfusions or pregnancies.
This group is growing on the kidney transplant waiting list each year because compatible donors cannot be found. If a compatible donor is found, the risk of rejection is much higher than in patients without prior sensitizations.
In recent years, various cell therapies have emerged to try to reduce the risk of developing rejection of the transplanted organ. All efforts have focused on patients who have living donors and do not have pre-existing sensitizations. Although the results of these therapies are quite promising, the majority of kidney transplants are performed using deceased donors, which prevents the use of these therapies.
What is autologous dendritic cell therapy?
Dendritic cells are cells of the immune system. Autologous tolerogenic dendritic cells (ATDCs) are specific cells that are taken from the patient themselves and modified in a laboratory to reduce the immune system's ability to attack the transplanted tissue. These cells act by promoting immune tolerance, regulating and balancing the immune response to decrease the risk of rejection of the new kidney without suppressing the immune system as a whole. ATDC therapy is an advanced therapy that seeks precise and individualized modulation of the immune system to protect the transplant.
Advanced therapies in sensitized patients
To make progress in the introduction of cell therapies in sensitized patients, Dr Fritz Diekmann, head of the Kidney Transplant Section at the Clínic and of the IDIBAPS Nephrology and Transplantation Group, coordinates a multicentre clinical trial, in which all transplant centres in Catalonia and Aragon, as well as the Catalan Transplant Organization (OCATT), are participating. The project is funded by the Carlos III Health Institute through the Independent Clinical Research programme (2021).
The aim of the study is to identify 30 highly sensitized patients, who will undergo a leukapheresis, a process that allows white blood cells to be separated and extracted from a patient's blood. From this sample, the therapeutic product is produced at the Clinic's Advanced Therapies Unit and is cryopreserved, frozen at very low temperatures, until the kidney transplant.
When the time for the transplant arrives, the logistics system is activated to thaw and administer the ATDC therapy between days 1 and 3 after the procedure.
To date, eight patients in their thirties have been enrolled, with the programme running until June 2026. So far, all initiated therapeutic products have completed production, meeting quality standards.
