Experience with belatacept rescue therapy in kidney transplant recipients
Brakemeier S, Kannenkeril D, Duerr M, Braun T, Bachmann F, Schmidt D, Wiesener M, Budde K (2016)
Publication Type: Journal article
Publication year: 2016
Journal
Book Volume: 29
Pages Range: 1184-1195
Journal Issue: 11
DOI: 10.1111/tri.12822
Abstract
In kidney transplant recipients with chronic graft dysfunction, long-term immunosuppression with calcineurin inhibitors (CNIs) or mTOR inhibitors (mTORi) can be challenging due to adverse effects, such as nephrotoxicity and proteinuria. Seventy-nine kidney transplant recipients treated with CNI-based or mTORi-based maintenance immunosuppression who had CNI-induced nephrotoxicity or severe adverse events were switched to belatacept. Mean time from transplantation to belatacept conversion was 69.0 months. Mean estimated glomerular filtration rate (eGFR) ± standard deviation at baseline was 26.1 ± 15.0 ml/min/1.73 m(2) , increasing to 34.0 ± 15.2 ml/min/1.73 m(2) at 12 months postconversion (P < 0.0005). Renal function improvements were also seen in patients with low eGFR (<25 ml/min/1.73 m(2) ) or high proteinuria (>500 mg/l) at conversion. The Kaplan-Meier estimates for patient and graft survival at 12 months were 95.0% and 85.6%, respectively. The discontinuation rate due to adverse events was 7.9%. One case of post-transplant lymphoproliferative disorder occurred at 17 months postconversion. For comparison, a historical control group of 41 patients converted to mTORi-based immunosuppression because of biopsy-confirmed CNI-induced toxicity was examined; eGFR increased from 27.6 ± 7.2 ml/min/1.73 m(2) at baseline to 31.1 ± 11.9 ml/min/1.73 m(2) at 12 months (P = 0.018). Belatacept-based immunosuppression may be an alternative regimen for kidney transplant recipients with CNI- or mTORi-induced toxicity.
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Germany (DE)How to cite
APA:
Brakemeier, S., Kannenkeril, D., Duerr, M., Braun, T., Bachmann, F., Schmidt, D.,... Budde, K. (2016). Experience with belatacept rescue therapy in kidney transplant recipients. Transplant International, 29(11), 1184-1195. https://dx.doi.org/10.1111/tri.12822
MLA:
Brakemeier, Susanne, et al. "Experience with belatacept rescue therapy in kidney transplant recipients." Transplant International 29.11 (2016): 1184-1195.
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