title: Belatacept Conversion in an HIV-Positive Kidney Transplant Recipient With Prolonged Delayed Graft Function.
abstract: We report an HIV-positive renal transplant recipient with delayed graft function who was converted from tacrolimus to belatacept in an attempt to improve renal function. The patient had kidney biopsies at 4 and 8 weeks posttransplant that revealed acute tubular necrosis and mild fibrosis. After 14 weeks of delayed function, belatacept was initiated and tacrolimus was weaned off. Shortly after discontinuing tacrolimus, renal function began to improve. The patient was able to discontinue dialysis 21 weeks posttransplant. HIV viral load was undetectable at last follow-up. To our knowledge, this is the first report of belatacept use in a patient with HIV.
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY.|Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Z
authors.initials: Z
authors.lastname: Ebcioglu
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY.
authors.forename: C
authors.initials: C
authors.lastname: Liu
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY.
authors.forename: R
authors.initials: R
authors.lastname: Shapiro
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: M
authors.initials: M
authors.lastname: Rana
authors.affiliation: Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: F
authors.initials: F
authors.lastname: Salem
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY.
authors.forename: S
authors.initials: S
authors.lastname: Florman
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: S
authors.initials: S
authors.lastname: Huprikar
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY. vinay.nair@mountsinai.org.|Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. vinay.nair@mountsinai.org.
authors.forename: V
authors.initials: V
authors.lastname: Nair
mesh_terms: D000069594:Abatacept / Q000627:therapeutic use*; D051799:Delayed Graft Function / Q000188:drug therapy*; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000517:prevention & control*; D006085:Graft Survival; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D066027:Transplant Recipients
chemical_list: D007166:Immunosuppressive Agents; D000069594:Abatacept
keywords: clinical research/practice; delayed graft function (DGF); fusion proteins and monoclonal antibodies: belatacept; immunosuppressant; immunosuppression/immune modulation; immunosuppressive regimens; infection and infectious agents; infectious disease; kidney transplantation/nephrology; maintenance; viral: human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)