Belatacept Combined With Transient Calcineurin Inhibitor Therapy Prevents Rejection and Promotes Improved Long-Term Renal Allograft Function

• DOI: 10.1111/ajt.14353
• Publication Date: 2017-05-24T00:54:43Z
• Authors: A.B. Adams; J. Goldstein; C. Garrett; R. Zhang; R.E. Patzer; K.A. Newell; N.A. Turgeon; A.S. Chami; A. Guasch; A.D. Kirk; S.O. Pastan; T.C. Pearson; C.P. Larsen
• Keywords: Belatacept; Immunosuppression; Regimen

Belatacept, a T cell costimulation blocker, demonstrated superior renal function, lower cardiovascular risk, and improved graft patient survival in transplant recipients. Despite the potential benefits, adoption of belatacept has been limited part due to concerns regarding higher rates grades acute rejection clinical trials. Since July 2011, we have utilized belatacept-based immunosuppression regimens practice. In this retrospective analysis 745 patients undergoing transplantation at our center, compared treated with (n = 535) historical cohort receiving tacrolimus-based protocol 205). Patient were equivalent for all groups. An increased rate was observed an initial similar low-intensity regimen from BENEFIT trial versus tacrolimus group (50.5% vs. 20.5%). The addition transient course reduced acceptable levels (16%). Treatment associated estimated GFR (belatacept 63.8 mL/min 46.2 4 years, p < 0.0001). There no differences serious infections including cytomegalovirus or BK viremia. We describe development costimulatory blockade-based strategy that ultimately allows recipients achieve calcineurin inhibitor-free immunosuppression.