CAR T cells for HLA desensitization: a new era in kidney transplantation

Abstract

In a recent study published in the New England Journal of Medicine , autologous CD19-and BCMA-directed chimeric antigen receptor (CAR) T-cell therapy was evaluated as a desensitization strategy in two highly sensitized kidney transplant candidates. 1 In this safety run-in cohort of an ongoing phase I clinical trial (NCT06056102), CAR T-cells reduced anti-human leukocyte antigen (HLA) antibody levels, enabling transplantation and providing the fi rst clinical proof-of-concept for CAR T-cell-based HLA desensitization.Anti-HLAantibodies remain a major obstacle to kidney transplantation. Sensitization is quanti fi ed using the calculated panel reactive antibody (cPRA) score, to estimate the percentage of potential organ donors expected to be incompatible (Fig. 1a).