NICE decision brings transplant hope to highly sensitised patients

17 June 2022

Kidney Research UK has welcomed a decision by the National Institute for Health and Care Excellence to recommend a treatment to enable people who are highly sensitised to have a kidney transplant without the organ being rejected.

What is imlifidase?

The new treatment, imlifidase, is produced by Hansa Biopharma who estimated there are over 100 highly sensitised patients awaiting kidney transplants in England and Wales.

People waiting for a transplant are highly sensitised if they have pre-formed antibodies known as human leukocyte antigens (HLA). These antibodies can cause the immune system to turn on a transplanted kidney which it views as a foreign or enemy tissue, which can lead to rejection.

These antibodies can develop if you have had previous blood transfusions, and certain blood types and pregnancy can increase the chances of developing sensitisation. This means some people from black, Asian or minority ethnic family backgrounds, and people who have been pregnant, are more likely to be highly sensitised.

Paul Cookson

There are few effective treatments currently available to tackle a patient’s antibody levels prior to transplant. Imlifidase works by quashing the antibodies prior to transplant, giving the transplanted kidney a greater chance of not being rejected.

The difference it could make

Paul Cookson, a kidney patient who has had four transplants rejected and has been been on dialysis for 20 years, explained the difference this could make to him;

"After my fourth transplant I was taken off the waiting list. This could be a game-changer for me, it would give me an option to come off dialysis three times a week."

“A lack of effective desensitization approaches has meant that until now, people who are classed as highly sensitized kidney patients have struggled to find a donor match, and have often had no alternative but to remain on long-term dialysis with a very poor quality of life,” says Dr Adnan Sharif, trustee at Kidney Research UK. “We welcome this decision which will allow new opportunities for certain highly sensitized patients in England and Wales to qualify for a life-altering transplant, and gain freedom from dialysis. Decision making around who has access to the treatment is key, and the lifespan of the transplanted kidneys will need to be carefully monitored.”

Who should be offered it?

NICE recommends that imlifidase should be offered as a treatment option to adults who have a positive cross match with the donor and are unlikely to have a transplant under the available kidney allocation system.

Our thanks to the kidney patients who helped with our response to the NICE consultation on this treatment – your experiences are invaluable in this crucial decision-making. We are delighted that on 12/09/22 the Scottish Medicines Consortium also announced it is recommending imlifidase for use in highly sensitised patients

We are delighted that on 12/09/22 the Scottish Medicines Consortium also announced it is recommending imlifidase for use in highly sensitised patients.