The goal of this clinical trial is to determine whether belimumab can improve detection of circulating HLA-specific memory B cells to support safer and more effective donor organ allocation in highly sensitized kidney transplant candidates.
The main questions it aims to answer are:
Does treatment with belimumab change the antigen specificity profile of circulating HLA-specific memory B cells compared to pre-treatment measurements?
Does a delisting strategy that incorporates mobilized memory B cells improve the probability of donor organ allocation and reduce time to transplantation?
Participants will:
Receive a short course of belimumab treatment
Provide blood samples before and during treatment to assess memory B-cell profiles
Undergo evaluation for potential adjustment of unacceptable HLA specificities (delisting) based on test results
Be followed for donor organ allocation and transplantation outcomes