Highly sensitized patients represent one of the most challenging populations in kidney transplantation, facing prolonged waiting times, reduced access to compatible organs, and lower transplant rates even under conventional desensitization methods. For many, transplantation remains difficult to achieve.

Idefirix® (imlifidase) is an IgG-inactivating therapy based on a cysteine protease originating from Streptococcus pyogenes. Idefirix converts a positive crossmatch to negative within hours and enabling transplantation across immunological barriers that would otherwise preclude it.

This symposium brings together international and Australian transplant clinicians to review the current evidence base for Idefirix in highly sensitized kidney transplantation. Presentations will cover long-term efficacy and safety outcomes from controlled clinical studies, real-world experience, and early Australian practice, across both deceased and living donor settings.

Together, the faculty will move from evidence to bedside, distilling how this expanding body of data is reshaping the way clinicians identify, transplant, and care for patients once considered untransplantable.

Professor Steve Chadban is a full-time transplant physician/nephrologist, Head of the Department of Renal Medicine at Royal Prince Alfred Hospital and Professor of Medicine, University of Sydney, Australia. As a clinician-scientist he leads teams in basic science, clinical trials and transplant outcomes. He has published over 400 peer-reviewed papers, with 34,752 cites and H-index 98. Chadban is Past-President of the Transplantation Society of Australia and New Zealand, past chair of ANZDATA, advises Government on Transplantation and CKD, and is co-chair of the 2020 KDIGO Clinical Guidelines for assessment and management of candidates for Kidney Transplantation.

Dr. Robert A. Montgomery is the Chairman and Professor of Surgery at NYU Langone Health and the Director of the NYU Langone Transplant Institute. He received his Doctor of Medicine with Honor from the University of Rochester School of Medicine.  He received his Doctor of Philosophy from Balliol College, the University of Oxford, England in Molecular Immunology as a Fulbright Scholar.  Montgomery completed his general surgical training, multi-organ transplantation fellowship, and postdoctoral fellowship in Human Molecular Genetics at Johns Hopkins.  For over a decade he served as the Chief of Transplant Surgery and the Director of the Comprehensive Transplant Center at Johns Hopkins. 

Dr. Montgomery was part of the team that developed the laparoscopic procedure for live kidney donation.  He and the Hopkins team conceived the idea of the Domino Paired Donation (kidney swaps), the Hopkins protocol for desensitization of incompatible kidney transplant patients, performed the first chain of transplants started by an altruistic donor which has resulted in 11,000 transplants.  In 2021, he led the team that performed the first gene edited pig-to-human xenotransplant and has performed 10 pig heart and kidney xenotransplants into humans.  

Dr. Montgomery is a member of the National Academy of Medicine and the French Academy of Medicine.  He has authored over 350 peer-reviewed articles, cited more than 42,000 times and has an h-index of 107. Newsweek Magazine featured him as one of America’s Greatest Disruptors in December 2021.  He received the Liberty Science Center’s 2022 Genius Award.  Modern Healthcare named him one of the Top 25 Innovators in Healthcare.  In 2024, he received The Transplantation Society’s Starzl Innovation Award and the prestigious Jacobson Innovation Award of the American College of Surgeons. He was named one of Time’s 100 Most Influential People in the World and Time’s 100 Most Influential People in Health for 2025. He is a Chevalier of Ukraine having received the Order of Merit awarded by Volodymyr Zelenskyy on September 21, 2023 for his surgical care of Ukrainian patients during the war.  He is credited in the 2010 Guinness Book of World Records with the most kidney transplants performed in 1 day.  

Prof. Lionel Couzi is a transplant nephrologist since 2003, with a PhD in Immunology obtained in 2010 for his work on the role of gamma delta T cells during CMV infection. After a postdoctoral fellowship at Guy’s Hospital in London, he was appointed Professor of Nephrology in 2015 at the University of Bordeaux in the ImmunoConCept group. He leads the department of nephrology, transplantation, dialysis and the kidney transplant program at Bordeaux University Hospital. His research topics are CMV infection, cell therapy, and recipients at risk of rejection. He has published more than 220 articles and has given more than 100 invited scientific conferences. He is secretary of the French Society of Transplantation and a member of the National Council of Universities.

Associate Professor Peter Hughes qualified from Monash University and undertook his advanced training at the Royal Melbourne Hospital (RMH) and Austin Hospital.

He was awarded an NHMRC scholarship to perform a PhD at the Walter and Eliza Hall Institute.

He has been a consultant nephrologist at the RMH since 2008 and has been the physician in charge of kidney transplantation since 2012. His current research interests include transplanting across immunological barriers, non-invasive transplant biomarkers, measurement of alloimmunity and immunosuppression and the mechanisms of acute and chronic transplant injury.

In 2017 Peter was appointed as Director of the national Paired Kidney Exchange Program, now the ANZKX. Peter has numerous publications in peer-reviewed journals.