title: Beneficial effect of conversion to belatacept in kidney-transplant patients with a low glomerular-filtration rate.
abstract: Belatacept has been found to be efficient at preserving good kidney function in maintenance kidney-transplant patients. Herein, we report on the use of belatacept as a rescue therapy for two kidney-transplant patients presenting with severe adverse events after treatment with calcineurin inhibitors (CNIs) and mammalian target-of-rapamycin (mTOR) inhibitors. Two kidney-transplant patients developed severely impaired kidney function after receiving CNIs. The use of everolimus was associated with severe angioedema. Belatacept was then successfully used to improve kidney function in both cases, even though estimated glomerular-filtration rate before conversion was <20 mL/min. These case reports show that belatacept can be used as a rescue therapy, even if kidney function is very low in kidney-transplant patients who cannot tolerate CNIs and/or mTOR inhibitors.
authors: Department of Nephrology and Organ Transplantation, CHU Rangueil, TSA 50032, 31059 Toulouse Cedex 9, France.
authors: Julie
authors: J
authors: Belliere
authors: Université Paul Sabatier, 31062 Toulouse, France ; Department of Pathology, CHU Rangueil, 31059 Toulouse, France.
authors: Céline
authors: C
authors: Guilbeau-Frugier
authors: Department of Nephrology and Organ Transplantation, CHU Rangueil, TSA 50032, 31059 Toulouse Cedex 9, France.
authors: Arnaud
authors: A
authors: Del Bello
authors: Department of Nephrology and Organ Transplantation, CHU Rangueil, TSA 50032, 31059 Toulouse Cedex 9, France.
authors: Laure
authors: L
authors: Esposito
authors: Université Paul Sabatier, 31062 Toulouse, France ; Department of Pathology, CHU Rangueil, 31059 Toulouse, France.
authors: Caroline
authors: C
authors: Capuani
authors: Department of Nephrology and Organ Transplantation, CHU Rangueil, TSA 50032, 31059 Toulouse Cedex 9, France.
authors: Isabelle
authors: I
authors: Cardeau-Desangles
authors: Department of Nephrology and Organ Transplantation, CHU Rangueil, TSA 50032, 31059 Toulouse Cedex 9, France ; Université Paul Sabatier, 31062 Toulouse, France ; INSERM U1043, IFR-BMT, CHU Purpan, 31059 Toulouse, France.
authors: Lionel
authors: L
authors: Rostaing
authors: Department of Nephrology and Organ Transplantation, CHU Rangueil, TSA 50032, 31059 Toulouse Cedex 9, France ; Université Paul Sabatier, 31062 Toulouse, France ; INSERM U1043, IFR-BMT, CHU Purpan, 31059 Toulouse, France.
authors: Nassim
authors: N
authors: Kamar