title: Belatacept prophylaxis against organ rejection in adult kidney-transplant recipients.
abstract: End-stage renal disease is a major health problem worldwide, with kidney transplantation being the treatment of choice. Calcineurin inhibitors are still the cornerstone of immunosuppressive therapy. However, they have well-known nephrotoxic affects and increase the risk of cardiovascular disease and cancer. In contrast, belatacept is a biological immunosuppressive agent that inhibits the T-cell co-stimulation. It is approved by the US Food and Drug Administration and the European Medicine Agency for use in adult kidney-transplant recipients to prevent acute rejection. Developmental studies show that belatacept is as efficient as calcineurin inhibitors at preventing acute rejection. In addition, kidney function is better and cardiovascular risk factors are reduced in patients given belatacept. Herein, the authors review the published evidence concerning the efficacy and safety of belatacept and discuss its potential specific indications.
authors.affiliation: a Department of Nephrology and Organ Transplantation , CHU Rangueil , Toulouse , France.|b Faculte de Medecine , Université Paul Sabatier , Toulouse , France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Del Bello
authors.affiliation: a Department of Nephrology and Organ Transplantation , CHU Rangueil , Toulouse , France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Marion
authors.affiliation: a Department of Nephrology and Organ Transplantation , CHU Rangueil , Toulouse , France.
authors.forename: David
authors.initials: D
authors.lastname: Milongo
authors.affiliation: a Department of Nephrology and Organ Transplantation , CHU Rangueil , Toulouse , France.|b Faculte de Medecine , Université Paul Sabatier , Toulouse , France.|c INSERM U1043, IFR-BMT, CHU Purpan , Toulouse , France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Rostaing
authors.affiliation: a Department of Nephrology and Organ Transplantation , CHU Rangueil , Toulouse , France.|b Faculte de Medecine , Université Paul Sabatier , Toulouse , France.|c INSERM U1043, IFR-BMT, CHU Purpan , Toulouse , France.
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar
mesh_terms: D000069594:Abatacept / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000818:Animals; D065095:Calcineurin Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods*; D066027:Transplant Recipients
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D000069594:Abatacept
keywords: Immunosuppressive therapy; belatacept; calcineurin inhibitor avoidance; co-stimulation; kidney transplantation; rejection