 A number of groups have studied methods to lower specific antibody levels in a variety of clinical settings. The two primary methods used today in transplantation are plasmapheresis the separation of plasma from cells, and the removal of solutes, immune globulins, and medications and administration of immune globulin therapy. Employing either of these techniques individually or jointly has substantially reduced acute rejection and improved kidney survival in these highly sensitized patients. The immune globulin treatments that have been studied have included large variations in dosage as well as differences in immune globulin products. The results from these small studies have not identified one therapy, product or dosage that could be considered standard of care. 