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Sensitization to human leukocyte antigens (HLA) antigens is the main obstacle to getting the kidney either from a living or deceased donor. HLA sensitization occurs as the result of repeated pregnancy, blood transfusion, or previous transplantation. Overcoming the HLA incompatibility is one of the approaches to decrease the organ shortage. There are 3.5 % highly sensitized patients among 3012 patients on the waiting list for kidney transplantation in Kazakhstan.<br /> In this review, we have discussed most common approaches of desensitization for HS kidney recipients. Huge progress has been made in the field of desensitization in transplant medicine worldwide. We suppose, that implementation the desensitization protocols in clinical guidelines will improve patient survival and outcome after kidney transplantation.