Impact of Belatacept Conversion on Renal Function, Histology, and Gene Expression in Kidney Transplant Patients With Chronic Active Antibody-mediated Rejection.

Transplantation
Dhiren KumarG Gupta

Abstract

Here, we present our initial experience with a prospective protocol of belatacept conversion in patients with chronic active antibody-mediated rejection (caAMR) and a high degree of chronicity at the time of diagnosis. We converted 19 patients (mean age, 45 ± 12 y) with biopsy-proven caAMR from tacrolimus to belatacept at a median of 44 months post-kidney transplant. At a median of 29 months (interquartile range, 16-46 mo) postconversion, death-censored graft and patient survivals were 89% and 95%, respectively. When compared to a 1:2 propensity-matched control cohort from the INSERM U970 registry maintained on calcineurin inhibitor, the belatacept group had progressive improvement (P = 0.02) in estimated glomerular filtration rate from a mean of 33.9 ± 10 at baseline to 37.8 ± 13 at 6 months and 38.5 ± 12 mL/min/1.73 m2 at 12 months postconversion, as compared to a steady decline noted in the controls (36.2 [baseline] → 33.1 [6 mo] → 32.7 mL/min/1.73 m2 [12 mo] of follow-up). A paired histologic comparison of preconversion and postconversion (performed at median 9.5 mo postconversion) biopsies showed no worsening in microvascular inflammation or chronicity. The paired tissue gene expression analysis showed improved mean total ...Continue Reading

References

Apr 26, 2007·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·G EineckeP F Halloran
Oct 5, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·G EineckeP F Halloran
Oct 12, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P F HalloranB Sis
Nov 6, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Lionel RostaingJosep Grinyó
Jan 25, 2011·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Bertram L KasiskeUNKNOWN Patient Outcomes in Renal Transplantation (PORT) Investigators
Nov 16, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J SellarésP F Halloran
Feb 22, 2012·Journal of the American Society of Nephrology : JASN·Konrad S FamulskiPhilip F Halloran
Dec 21, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·E J KimS J Knechtle
Apr 5, 2014·Journal of the American Society of Nephrology : JASN·Alexandre LoupyPhilip F Halloran
Oct 12, 2014·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Hari TalrejaGreg Knoll
May 20, 2015·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·G GuptaA L King
Jan 9, 2016·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P F HalloranA Barreto Pereira
Jan 28, 2016·The New England Journal of Medicine·Flavio VincentiChristian P Larsen
Aug 9, 2016·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·S KulkarniJ S Pober
Feb 16, 2017·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J ChoiS C Jordan
Apr 4, 2017·Kidney International·Ngan N LamScott Klarenbach
Apr 28, 2017·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P F HalloranA Loupy
Sep 28, 2017·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Francesc MoresoDaniel Seron
Dec 16, 2017·Journal of the American Society of Nephrology : JASN·Farsad EskandaryGeorg A Böhmig
Dec 16, 2017·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M HaasM Mengel
Mar 16, 2019·Journal of the American Society of Nephrology : JASN·Olivier AubertAlexandre Loupy
Jul 17, 2019·Journal of the American Society of Nephrology : JASN·Philip A ClaytonSteven J Chadban

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Citations

Dec 18, 2020·Current Opinion in Organ Transplantation·Ondrej ViklickyPetra Hruba

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