Researchers at the University of Pennsylvania successfully used dual CAR T-cell therapy to desensitize three kidney transplant patients who had near-zero odds of finding a compatible donor. Published in the New England Journal of Medicine, the phase I trial targeted two immune cell types — CD19 and BCMA — to eliminate the anti-HLA antibodies blocking transplant compatibility. Both patients treated had calculated panel-reactive antibody scores of 99.9% or higher, meaning almost no donor kidneys would work for them. The therapy was well-tolerated and antibody levels have not rebounded. Around 5,000 Americans on the kidney transplant waitlist face this extreme sensitization, leaving them at high risk of dying before a match is found. This approach could offer a transformative solution.
