Early Conversion to Belatacept in Kidney Transplant Recipients With Low Glomerular Filtration Rate

Transplantation
Dina Abdelwahab ElhamahmiBruce Kaplan

Abstract

Our aim was to determine the impact of converting from tacrolimus to belatacept in patients with stable low estimated glomerular filtration rate (eGFR) early after kidney transplant. This is a single-center retrospective case control study. During this study period, we had a clinical protocol to convert patients to belatacept if they had a stable but low GFR and they were at least 1-month posttransplant. Eligible patients had stable but low eGFR usually < 40 mL/min per 1.73 m. We used direct matching to select 1 control case for each patient converted to belatacept. The primary outcome was the change in eGFR from the point of belatacept conversion to 4 months postconversion (delta eGFR). There were 30 patients in the conversion group and 30 in a direct matched control group. The median preconversion eGFR for the entire cohort was 23.0 mL/min per 1.73 m with an interquartile range of 15.7 to 31.4. The delta eGFR was 11.0 (12.9) mL/min per 1.73 m in belatacept group and 4.8 (10.5) mL/min per 1.73 m in the control group (P = 0.045). Acute rejection postconversion occurred in 5 (16.7%) in the conversion group and none of the control group (P = 0.052). Although the delta improvement in eGFR was about 6 mL/min better in the Belatacep...Continue Reading

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Citations

Nov 22, 2019·Drugs·Marieke van der ZwanCarla C Baan
Jan 23, 2021·Transplantation Proceedings·Mona YazdiRoland Lee
Aug 14, 2020·Transplant International : Official Journal of the European Society for Organ Transplantation·Gaurav GuptaPhilip F Halloran

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