title: Long-term outcome of belatacept therapy in de novo kidney transplant recipients - a case-match analysis.
abstract: While belatacept has shown favorable short- and midterm results in kidney transplant recipients, only projections exist regarding its potential impact on long-term outcome. Therefore, we performed a retrospective case-match analysis of the 14 belatacept patients originally enrolled in the phase II multicenter trial at our center. Fifty six cyclosporine (CyA)-treated patients were matched according to age at transplantation, first/retransplant, and donor type. Ten years after kidney transplantation, kidney function remained superior in belatacept-treated patients compared with the CyA control group. Moreover, none of the belatacept-treated patients had donor-specific antibodies ≥10 years post-transplantation compared with 38.5% of tested CyA-treated subject (0/10 vs. 5/13; P = 0.045). Notably, however, patient and graft survival was virtually identical in both groups (71.4% vs. 71.3%; P = 0.976). In the present single-center study population, patients treated with belatacept demonstrated a patient and graft survival at 10 years post-transplant which was comparable to that of similarly selected CNI-treated patients. Larger studies with sufficient statistical power are necessary to definitively determine long-term graft survival with belatacept.
authors.affiliation: Division of Transplantation/Department of Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schwarz
authors.affiliation: Division of Transplantation/Department of Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Sophie
authors.initials: S
authors.lastname: Mayerhoffer
authors.affiliation: Division of Transplantation/Department of Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Gabriela A
authors.initials: GA
authors.lastname: Berlakovich
authors.affiliation: Division of Transplantation/Department of Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Steininger
authors.affiliation: Division of Transplantation/Department of Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Soliman
authors.affiliation: Division of Nephrology and Dialysis/Department of Internal Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Bruno
authors.initials: B
authors.lastname: Watschinger
authors.affiliation: Division of Nephrology and Dialysis/Department of Internal Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Georg A
authors.initials: GA
authors.lastname: Böhmig
authors.affiliation: Division of Nephrology and Dialysis/Department of Internal Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Farsad
authors.initials: F
authors.lastname: Eskandary
authors.affiliation: Section for Medical Statistics, Medical University of Vienna, Vienna, Austria.
authors.forename: Franz
authors.initials: F
authors.lastname: König
authors.affiliation: Division of Transplantation/Department of Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Mühlbacher
authors.affiliation: Division of Transplantation/Department of Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wekerle
mesh_terms: D000069594:Abatacept / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis / Q000276:immunology / Q000401:mortality / Q000517:prevention & control*; D006085:Graft Survival / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000401:mortality; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D000069594:Abatacept; D016572:Cyclosporine
keywords: belatacept; immunosuppression; kidney transplantation; long-term outcome