Background: Sensitization to human leukocyte antigens remains a major barrier to successful renal transplantation.
Material and Methods: Herein we describe our experience of   seven highly sensitized patients with positive T-cell and B- cell lymphocytotoxicity crossmatch and T and B-cell flow crossmatch for IgG.  All seven patients had donor specific antibodies (DSA) against HLA class I or class II antigens detected by Luminex single antigen beads assay (SAB).Desensitization protocol included 7-10 session of plasmapheresis, Low dose IVIgG, single dose of Rituximab and two doses of Bortezomib.
Results: In all cases CDC and flow crossmatch were negative at the time of transplant.  Three patients experienced rejection episode from 18 days to 3 months post-transplant. In a follow-up period of 2 to 12 months post -transplant   all allografts are functioning well with mean serum creatinine is 1.25mg/dl.
Conclusion: The early results of this study are encouraging. Protocols employed in the current study offer real hope to these patients unlikely to otherwise receive a kidney transplant.