Thirteen years spent waiting for a compatible organ, between dialysis sessions, medical checks and the knowledge that the chances of receiving a new kidney were extremely small. Then an experimental therapy, capable of intervening on one of the most complex obstacles in transplant medicine, changed the prospects of two patients who until a few months earlier seemed destined to remain excluded from the possibility of an operation.
It happened at the Sant’Orsola Polyclinic in Bologna, where two people on the waiting list for about 13 years have received a kidney transplant thanks to an innovative anti-rejection drugcizutamig, developed by the US biotechnology company Candid Therapeutics. A result presented on November 4, 2026, which represents one of the first successes in the world in using this therapeutic strategy for highly immunized patients.
What makes the achievement particularly significant is not only the success of the operations, but the fact that both patients had immunological characteristics that made it almost impossible to identify a compatible donor. The new treatment has made it possible to overcome this barrier, opening up perspectives that were difficult to imagine until now for a category of patients who often remain on the waiting list for many years.
Thirteen years waiting for a kidney: why the transplant seemed impossible
The protagonists of the story are Roberto Mazzotti, resident in the Ravenna area, and Maria-Chiara Negri, from the Bolognese area. Both had a long history of renal failure and dialysis, but above all a condition of hyperimmunization which had progressively reduced the chances of receiving an organ.
In these patients, the immune system produces high quantities of antibodies capable of recognizing the tissues of a potential donor as foreign. This is a mechanism that normally serves to protect the organism, but which in the case of a transplant can become a decisive obstacle, increasing the risk of rejection and making it extremely difficult to find a compatible kidney.
For thirteen years the checks carried out on possible donors had not allowed us to identify a viable solution. A situation that entailed not only the need to continue dialysis, but also a significant impact on the quality of life, on the possibility of working, traveling and organizing one’s daily life.
After the surgery, Roberto Mazzotti said that the treatment completely changed his life. Even Maria-Chiara Negri, after years marked by dialysis sessions, described the return to a profoundly different daily life, in which it finally becomes possible to imagine projects that were unattainable until recently.
How cizutamig works, the drug that made the transplant possible
The scientific novelty concerns the mechanism of action of cizutamig, a bispecific antibody designed to act directly on the cells that produce the antibodies responsible for the incompatibility.
Unlike some traditional desensitization strategies, which aim above all to temporarily reduce the amount of antibodies circulating in the blood, the new drug acts on plasma cells, the cells of the immune system that produce them.
The molecule is able to bind simultaneously to two targets: BCMA, present on plasma cells, and CD3, associated with T lymphocytes. In this way it favors the proximity of immune cells to the plasma cells to be eliminated, with the aim of reducing the production of antibodies that prevent the transplant at the source.
In the case of the two patients treated in Bologna, the therapy resulted in a progressive decrease in anti-HLA antibodies and those specifically directed against the donor, making it finally possible to proceed with the surgical procedure.
A particularly encouraging aspect is that the reduction in antibodies continued even after the transplant, suggesting the possibility of obtaining a more lasting effect compared to that of treatments that only intervene on the antibodies already present in the blood.
The record of Sant’Orsola of Bologna and the results after the intervention
The result was achieved by the team of the Kidney Transplant Center of the Sant’Orsola Polyclinic, directed by Professor Gaetano La Manna, with the contribution of Professor Giorgia Comai for the nephrological and immunological aspects and Professor Matteo Ravaioli for the surgical ones.
Bologna treated the first patient in the world with this strategy, while the second case was carried out in Barcelona and the third again in the Emilian capital. The project also involves the Charité Universitätsmedizin of Berlin, as part of an international collaboration dedicated to the development of new therapeutic possibilities.
A few months after the operations, both patients present good functionality of the transplanted kidney and favorable clinical conditions. Maintaining the reduction of antibodies is also an important element, although continued monitoring will be necessary to verify the duration of the response and the safety of the therapy in the long term.
The results were also presented at the American Society of Nephrology congress, helping to fuel the interest of the scientific community in a strategy that could profoundly change the approach to the most difficult patients to transplant.
A new hope for those waiting for a kidney transplant
The issue affects a significant portion of the people on the waiting list. According to what was reported by the Sant’Orsola Polyclinic, hyperimmunization conditions affect approximately 30% of patients awaiting a transplant, although the degree of incompatibility and the difficulties in identifying a donor can vary considerably from person to person.
For more complex cases, the presence of antibodies directed against numerous potential donors can translate into very long waits and extremely limited possibilities of transplantation. It is precisely in this area that a strategy capable of modifying the immune response could take on decisive importance.
However, it is necessary to distinguish the encouraging results obtained in Bologna from the availability of an already consolidated therapy. Cizutamig is still an experimental drugused in these cases through a compassionate use program, which allows access to medicines not yet authorized or marketed in particular clinical circumstances.
Further studies will be necessary to establish its efficacy, safety, possible side effects and long-term benefits, as well as to precisely identify which patients will benefit most from it. Furthermore, the treatment does not eliminate the need for immunosuppressive therapies and the checks required after a transplant.
However, an important result remains for transplant medicine: two people who had not found a compatible organ for thirteen years were finally able to receive a kidney. And a barrier that until now seemed almost insurmountable may, at least for some patients, no longer be.
