Isatuximab in Lung Transplant Recipients

Inclusion Criteria: Cohort A (Desensitization) Inclusion Criteria: * Age ≥ 18 years * Listed and will receive a lung transplant or multi-organ transplant involving a lung at NYU Langone Health that is deemed to require peri-transplant desensitization * Able and willing to provide informed consent * Pre-transplant DSA \> 5,000 MFI in undiluted serum (measured as individual DSA MFI or as sum of multiple DSAs \>1000 MFI in the undiluted serum) Cohort B (AMR) Inclusion Criteria: * Age ≥ 18 years * Received a lung transplant or multi-organ transplant involving a lung at NYU Langone Health * Able and willing to provide informed consent * Allograft dysfunction in the setting of at least one of the following criteria: * Histopathology suggestive of AMR * Lung biopsy demonstrating C4d deposition * Positive DSA \> 2,000 MFI (as individual DSA MFI) Exclusion Criteria: * Prior or current treatment with rituximab within 6 months of isatuximab administration * Prior or current treatment with tocilizumab within 6 months of isatuximab administration * Contraindication to isatuximab due to intolerance or hypersensitivity * Pregnant or breastfeeding women * Known malignancy * Active infection without adequate treatment or source control * Known hepatitis B viral infection * Known HIV infection