Use of belatacept to maintain adequate early immunosuppression in calcineurin‐mediated microangiopathic hemolysis post‐renal transplant

• DOI: 10.1111/petr.12278
• Publication Date: 2014-05-12T08:25:03Z
• Authors: B. C. Reynolds; D. Talbot; L. Baines; A. Brown
• Keywords: Belatacept; Immunosuppression; Microangiopathic hemolytic anemia; Plasmapheresis

Abstract We report a 17‐yr‐old boy who developed microangiopathic hemolytic anemia presumed secondary to tacrolimus shortly following living‐related donor renal transplant. This was initially managed by plasmapheresis. Reinstitution of calcineurin inhibition using cyclosporine led recurrence hemolysis, so an alternative agent needed. He commenced on monthly intravenous belatacept, with no further the and subsequent stable graft function. Modulation via CTLA ‐4 offers immunosuppressive tactic if current regimens produce threatening adverse effects. The method administration frequency dosage belatacept also lends itself well high‐risk period adolescence transition. propose that may therefore have utility in difficult cases complicated poor concordance, common adolescent age group.