1 Department of Nephrology, Ibn Sina Teaching Hospital, Sirte, Libya.
2 Department of Urology, Ibn Sina Teaching Hospital, Sirte, Libya.
3 Chief Medical Officer (CMO) and Hospital Director, Ibn Sina Teaching Hospital, Sirte, Libya.
4 Department of Internal Medicine, Ibn Sina Teaching Hospital, Sirte, Libya.
5 Department of Human Resources and Research, Ibn Sina Teaching Hospital, Sirte, Libya.
6 Department of Intensive Care Unit (ICU), Ibn Sina Teaching Hospital, Sirte, Libya.
7 Department of Nephrology, Arab Renal Care Group (ARCG), Amman, Jordan.
World Journal of Advanced Research and Reviews, 2026, 29(02), 609-612
Article DOI: 10.30574/wjarr.2026.29.2.0267
Received on 30 December 2025; revised on 07 February 2026; accepted on 09 February 2026
Highly sensitized kidney transplant candidates face significant immunologic barriers due to high donor-specific antibody (DSA) titers. This study reports the first two highly sensitized living-related kidney transplant recipients successfully desensitized at Ibn Sina Teaching Hospital, Sirte, Libya, using plasmapheresis and rituximab without IVIG. Both patients exhibited DSA >5000 Mean Fluorescence Intensity (MFI) pre-desensitization. After 5–7 plasmapheresis sessions and rituximab, DSA levels fell below 500 MFI, permitting safe transplantation. Both received ATG induction and standard maintenance therapy. Immediate graft function occurred with serum creatinine <1 mg/dL at 72 hours. No delayed graft function, rejection, or infection occurred. These findings demonstrate that simplified desensitization can expand transplant access in developing countries.
Kidney Transplant; Highly Sensitized Recipient; Donor-Specific Antibodies; Plasmapheresis; Rituximab; Desensitization; Living Donor Transplantation; ATG Induction; HLA Antibodies; Libya
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Mohamed Aboalgasem, Omran Aburqiqa, Erfai M. Emtair, Ali Khalifa Eljerroshi, Gadalla Diryag, Muammar Makhlouf, Ali Aboubakr F. Abd Alraheem and Issa Kawalit. Successful desensitization and early outcomes in two highly sensitized living-related kidney transplant recipients at IBN Sina Teaching Hospital, Sirte, Libya. World Journal of Advanced Research and Reviews, 2026, 29(02), 609-612. Article DOI: https://doi.org/10.30574/wjarr.2026.29.2.0267.
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