Journal of Transplantation 2014 :14;272-283 page 277. De-sensitisation of patients to increase the Consistent criteria have been developed likelihood of transplantation across both Kidney and Solid organ Treatment or prevention of graft transplantation (other than kidney) for rejection where conventional Highly sensitised patient with known sensitisation of patients to increase the immunosuppressive therapies is antibody(ies) of at least 1000 Mean likelihood of transplantation’. Evidence items contraindicated or pose a threat to the Fluorescence Intensity (MFI) will capture the type(s) of HLA Ab, the MFI graft or patient and testing platform. AND Conventional immunosuppressive therapy is contraindicated and reason is Circumstances indicate that the likelihood provided. of receiving an organ is very low Treatment of ongoing active antibody mediated rejection Evidence items for ‘ongoing active antibody mediated rejection’ will include the date of Ongoing antibody mediated rejection as organ transplant, key biopsy findings and demonstrated by biopsy in accordance confirmation that BANFF criteria are met. with BANFF criteria Review No review is required for one-off Immediate pre-transplant where donor specific Outcome measures for first three indications Criteria dosing antibody/ies prevent transplantation (HLA or have been developed. group) in highly sensitised patients Review is not mandated for this indication however the following criteria may be useful in assessing the effectiveness of therapy. Clinical effectiveness of Ig therapy may be demonstrated by: Reduction in antibody level
Journal of Transplantation 2014 :14;272-283 page 277. Treatment or prevention of graft rejection where conventional immunosuppressive therapies is contraindicated or pose a threat to the graft or patient Conventional immunosuppressive therapy is contraindicated and reason is provided. De-sensitisation of patients to increase the likelihood of transplantation Highly sensitised patient with known antibody(ies) of at least 1000 Mean Fluorescence Intensity (MFI) AND Circumstances indicate that the likelihood of receiving an organ is very low Treatment of ongoing active antibody mediated rejection Ongoing antibody mediated rejection as demonstrated by biopsy in accordance with BANFF criteria Consistent criteria have been developed across both Kidney and Solid organ transplantation (other than kidney) for of patients to increase the likelihood of transplantation’. Evidence items will capture the type(s) of HLA Ab, the MFI and testing platform. Evidence items for ‘ongoing active antibody mediated rejection’ will include the date of organ transplant, key biopsy findings and confirmation that BANFF criteria are met. Review Criteria No review is required for one-off dosing Immediate pre-transplant where donor specific antibody/ies prevent transplantation (HLA or group) in highly sensitised patients Review is not mandated for this indication however the following criteria may be useful in assessing the effectiveness of therapy. Clinical effectiveness of Ig therapy may be demonstrated by: Reduction in antibody level Outcome measures for first three indications have been developed. sensitisation