Comparison of de novo IgM and IgG anti-HLA DSAs between belatacept- and calcineurin-treated patients: An analysis of the BENEFIT and BENEFIT-EXT trial cohorts

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Matthew J EverlyHoward M Gebel

Abstract

Preventing conversion of donor-specific anti-HLA antibodies (DSAs) from an IgM-to-IgG could a way to prevent chronic rejection. We evaluated whether belatacept-treated patients (belatacept less-intensive [LI] or more-intensive [MI] regimens) have a lower rate of conversion than do cyclosporine A (CsA)-treated patients. We included 330 HLA-mismatched patients from 2 phase 3 trials with either (a) complete donor/recipient HLA-A, -B, -DR, and -DQ loci typing or (b) incomplete HLA typing with IgG DSAs detected pretransplant or posttransplant. IgM and IgG DSAs were tested with single antigen beads at 0, 6, 12, 24, and 36 months posttransplant. The overall (preexisting or de novo) rates of IgM- and IgG-positive DSAs were 29% and 34%, respectively. The pretransplant IgM and IgG DSA-positive frequencies were similar between treatment groups. The IgG-positive dnDSA rate was significantly higher in the CsA-treated group (34%) compared with the belatacept-LI (8%) and belatacept-MI (11%) (P < .001) groups. In IgM-positive dnDSA patients, the IgG-positive dnDSA rate of conversion was 2.8 times higher in the CsA group than in the combined belatacept groups (P = .006). However, the observed association between belatacept treatment and more li...Continue Reading

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Citations

Jan 25, 2019·Expert Review of Clinical Immunology·Johan NoblePaolo Malvezzi
Apr 8, 2019·Transplant International : Official Journal of the European Society for Organ Transplantation·Georg A BöhmigPhilip F Halloran
Jul 31, 2019·Transplant International : Official Journal of the European Society for Organ Transplantation·Caroline WehmeierStefan Schaub
Oct 3, 2019·Current Opinion in Organ Transplantation·Kentaro KadonoJerzy W Kupiec-Weglinski
Apr 4, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Dharmendra JainRonald P Pelletier
Jul 13, 2020·Clinical Transplantation·Andrew SanteusanioRon Shapiro
Aug 28, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Ronald F ParsonsHoward M Gebel
Mar 12, 2020·Current Transplantation Reports·Ronald F ParsonsI Raul Badell
Oct 13, 2020·Frontiers in Immunology·Dimitrios GiannisLinda C Cendales
Jan 23, 2021·Transplantation Proceedings·Mona YazdiRoland Lee
Aug 24, 2021·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Benjamin S MantellEmmanuel Zorn
Aug 26, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Florence HerrAntoine Durrbach

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