How can we deal with the sensitized patient on the waiting list
Stanley Jordan
Director, HLA and Transplant Immunology Laboratory, Comprehensive Transplant Center
Director, Division of Nephrology
Medical Director, Kidney Transplant Program
Cedars-Sinai
Professor, Medicine, UCLA
Los Angeles, USA
Dr. Jordan's life has and continues to be dedicated to improving transplantation rates for highly-HLA and ABO blood group incompatible transplant recipients. Our group has been an innovator in this area with many significant accomplishments. We developed the first desensitization protocol to reduce harmful anti-HLA antibodies in 1990. This evolved into 3 NIH funded UO1 Controlled Clinical Trials of which I was the PI. Our work resulted in the approval of IVIG as a desensitization agent by Medicare in the U.S. Thus, an idea that was initially developed in our laboratory evolved through clinical trials to an accepted therapeutic tool that is used in institutions around the world. We subsequently undertook clinical trials assessing the utility of rituximab and IVIG as desensitization agents.
This work also resulted in approval of this combination for treatment of highly-HLA sensitized patients. With these approvals, we developed our Transplant Immunotherapy Program at Cedars-Sinai in 2004. This program evolved to provide state-of-the-art therapies for difficult to transplant patients and also serves as a core research group for development of investigator-initiated trials aimed at prevention and treatment of antibody rejection. Among our current clinical trials is a placebo controlled trial of complement inhibition (C1 Inhibitor in Highly-HLA Sensitized Transplants, also a trial of C1INH for prevention of delayed graft function (Published Am. J. of Transplantation 2018) and a trial of IdeS (IgG endopeptidase for prevention of antibody mediated rejection )Published New England J. of Medicine 2017.
Importantly, we also published the first experience with anti-IL-6 receptor therapy for treatment of antibody mediated rejection (Am. J. of Transplantation, 2018). These are all unique investigator initiated studies performed at our center. Of importance is that IdeS and anti-IL-6 are in Phase 3 trials for FDA approval in kidney transplant patients. patients. I am very proud of our accomplishments, and look forward to improving the care of our patients through the controlled clinical trials process.
For more than three decades, Dr. Jordan has focused his research on the immunology of antibody rejection and development of novel immune modulatory therapies to combat this condition. His work is funded by the NIH and grants from biotechnology firms aimed at developing novel therapies in transplant medicine. He has published more than 383 peer reviewed manuscripts and has 10 patent applications pending.
Dr. Jordan has extensive experience with desensitization for incompatible kidney transplantation and currently has 14 investigator-initiated clinical trials examining novel therapies for desensitization and treatment of antibody-mediated rejection. He has also published novel clinical trials using complement inhibitors to prevent delayed graft function in renal allografts. Dr. Jordan and his work have been recognized by his peers and include his being the recipient of the National Kidney Foundation “Gift of Life Award” and the Distinguished Alumni Award from the University of North Carolina Chapel Hill. Recently, he was honored with the inaugural Cedars-Sinai Prize for Research in Scientific Medicine (PRISM), conceived to recognize outstanding scientific and medical breakthroughs, the Pioneer in Medicine Award (also from Cedars-Sinai), the Award for Outstanding Achievement in Transplantation (Clinical ) from the Transplantation Society, the Jean Hamburger Award for outstanding research in nephrology from the International Society of Nephrology the Senior Achievement Award in Clinical Transplantation from the American Society of Transplantation and the Mayo Soley Award for outstanding research and mentorship from the Western Society of Clinical Investigation.
Most recently, Dr. Jordan received the Medawar Prize from the Transplantation Society. The Medawar Prize, named after Society co-founder Sir Peter Medawar, Nobel Laurette 1960, is recognized as the world's highest dedicated award for the most outstanding contributions in the field of transplantation. The award recognizes the outstanding investigators whose contributions have had such a profound influence on the field of organ transplantation. The Medawar Prize is universally considered to be commensurate with the most outstanding world prizes for scientific achievement.
What are our local proposals for these patients?
Maria Gerbase de Lima
Director
Immunogenetics Institute (IGEN)
Associação Fundo de Incentivo à Pesquisa (AFIP
São Paulo, Brazil
Maria Gerbase de Lima (aka Maria Gerbase-DeLima), M.D., PhD. Director of the Immunogenetics Institute (IGEN), Associação Fundo de Incentivo à Pesquisa – AFIP, São Paulo, Brazil. Associate Professor at the Federal University of São Paulo Medical School, until 2009. Has more than 100 publications in peer-reviewed journals. Chaired the 15th International Histocompatibility Workshop that was held in Brazil, in 2008. Served twice as President of the Brazilian Association for Histocompatibility, was a member of the Board of Directors of the American Society for Histocompatibility and Immunogenetics (ASHI), and of the Brazilian Association for Organ Transplantation (ABTO). Presently is a TTS Councilor-at-Large - Latin America.
