imlifidase for desensitisation treatment before kidney transplant in people with chronic kidney disease

Last edited 07/2022 and last reviewed 10/2022

Imlifidase

  • is an IgG-degrading enzyme derived from Streptococcus pyogenes
  • is a novel agent that cleaves all four human subclasses of IgG and has therapeutic potential for HLA desensitization in kidney transplantation and antibody-mediated rejection
  • is a recombinant cysteine protease derived from S. pyogenes produced recombinantly in Escherichia coli which has the capacity to cleave all four human subclasses of IgG with precise specificity (1)

NICE guidance (2):

Imlifidase is recommended as a desensitisation treatment option for adults who:

  • are waiting for a kidney transplant from a deceased donor
  • are highly sensitised to human leukocyte antigens (HLA)
  • have a positive crossmatch with the donor and are unlikely to have a transplant under the available kidney allocation system (including prioritisation programmes for highly sensitised people)

It is recommended only if:

  • a maximum of 1 dose is given
  • it is given in a specialist centre with experience of treating high sensitisation to HLA
  • the company provides imlifidase according to the commercial arrangement

Reference:

Related pages:

kidney transplantation