A Bacterial IgG-Degrading Enzyme to Unhinge Antibodies

The number of patients awaiting renal transplantation heads ever upward (in the United States alone, more than 105,000 patients are currently on the waiting list for a kidney from a deceased donor, according to the United Network for Organ Sharing), and many of those patients are unlikely to receive kidneys, because they have preformed antibodies to HLA or other antigens.1 Such sensitized patients, if they ultimately receive kidneys at all, may wait years before an appropriate organ becomes available, unless the antibody titer diminishes, which is an unlikely event without therapy. Furthermore, many allografts — an estimated 5000 annually in . . .