Table 3.

Summary of DSA and desensitization methods used in HSCT and solid organ transplant studies.

Ref	Population	DSA Characteristics	Desensitization Modality
HSCT Patient Studies
(35)	13 haplo, 2 10/10 matched UD	DSA by HLA Class (no. patients): 9 Class I only (5 FCXM positive) 5 Class II only (5 FCXM positive) 1 Class I and Class II (1 FCXM positive)	1-6 TPE and IVIG (possible 1-2 TPE and IVIG post-transplant) Tacrolimus and MMF 1-2 weeks prior to conditioning
(44)	20 haplo	DSA by HLA Class (no. patients): 10 Class I only (6 >5,000 MFI) 4 Class II only (1 >5,000 MFI) 5 Class I and Class II (5 >5,000 MFI)	Various including rituximab, IVIG, TPE, incompatible platelet transfusions, buffy coat transfusion, MMF, tacrolimus, steroids
(34)	37 haplo	DSA by HLA Class (no. patients): 14 Class I 12 Class II 11 Class I and Class II All DSA 10,198 mean MFI >20,000 MFI (6), 10-20,000 MFI (6), and <10,000 MFI (20)	3 TPE and IVIG, rituximab, buffy coat transfusion
Solid Organ Transplant Patient Studies
(45)	45 renal transplant recipients (18 living, 27 deceased)	DSA by HLA loci (frequency): HLA-A 77.7%, HLA-B 63%, HLA-C 15% HLA-DR 44%, HLA-DQ 36%, HLA-DP 28% Living donor recipients: Class I 6,195 mean MFI Class II 2,191 mean MFI Deceased donors recipients: Class I 13,929 mean MFI Class II 5,508 mean MFI	Various regimens of rituxumab, tacrolimus, MMF, steroids pre-transplant Apheresis (immunoadsorption, double-filtration plasmapheresis, plasma exchange) – multiple courses of 4 sessions Thymoglobulin and IV steroids on day 1-5 post-transplant
(46)	56 renal transplant recipients	DSA by HLA loci (frequency): HLA-A 46.9%, HLA-B 35.9%, HLA-C 25% HLA-DR 48.4%, HLA-DR51-53 32.8%, HLA-DQ 54.7%, HLA-DP 15.6% 10 patients Class I only 22 patients Class II only 32 patients Class I and Class II	TPE and IVIG (mean 6.0 procedures)
HSCT Case Reports
(43)	9/10 RD	HLA-A*24:02 18,000 MFI pre-transplant to 2,233 MFI day 0 FCXM positive to negative	20 sessions TPE and IVIG 2 doses rituximab (day -31, -9)
(41)	9/10 URD	HLA-A2 >20,000 MFI pre-transplant to 4,500 day -1 CDC positive to FCXM negative	7 platelet infusions with A2 donor 4 doses rituximab 4 doses bortezomib
(45)	haplo	HLA-B*35:01 14,142 MFI pre-transplant to 449 MFI day +14	Multiple platelet infusions with B35 donors 1 dose rituximab (day -8) 3 doses IVIG (days -7, -6, -5)
(46)	10/10 URD	HLA-DRB4*01:01 10,258 MFI to 8,525 MFI post-treatment DRB4*01:03 12,987 MFI to 10,702 MFI post-treatment	Plasmapheresis Rituximab

RD, related donor; URD, unrelated donor; haplo, haploidentical donor; FCXM flow cytometric crossmatch. Numbers indicate number of patients unless otherwise noted as frequency or MFI.