title: Early conversion to belatacept after renal transplantation.
abstract: Belatacept is a non-nephrotoxic immunosuppressive agent, which may make it the ideal agent for patients with delayed or slow graft function on calcineurin inhibitors. There are limited data on conversion of patients to belatacept within 6 months of transplantation. Between January 2012 and December 2015, 16 patients were converted to belatacept for delayed or poor graft function (eGFR<30 mL/min/1.73 m2, MDRD); three were HIV positive. Conversion protocols were analyzed in patients ≤4 months and 4-6 months post-transplantation. Mean serum creatinine levels after belatacept conversion were compared with preconversion levels. Patient survival was 100%, and graft survival was 88%. The mean creatinine fell from 3.9±1.82 mg/dL prebelatacept conversion to 2.1±1.1 mg/dL at 6 months and 1.9±0.47 mg/dL (median 1.8 mg/dL) at 12 months postconversion. There was no significant increased risk of rejection, infection, or malignancy. HIV parameters remained largely stable. Early conversion to belatacept in patients with DGF or slow graft function is safe and efficacious, in a single-center nonrandomized retrospective analysis.
authors.affiliation: Department of Medicine, Hofstra Northwell School of Medicine, Great Neck, NY, USA.
authors.forename: Vinay
authors.identifier: 0000-0002-4427-165X
authors.initials: V
authors.lastname: Nair
authors.affiliation: Department of Medicine, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA.
authors.forename: Luz
authors.initials: L
authors.lastname: Liriano-Ward
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY, USA.|Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Kent
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Shirish
authors.initials: S
authors.lastname: Huprikar
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Mena
authors.initials: M
authors.lastname: Rana
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Sander S
authors.initials: SS
authors.lastname: Florman
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY, USA.|Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Veronica B
authors.initials: VB
authors.lastname: Delaney
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY, USA.|Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Madhav C
authors.initials: MC
authors.lastname: Menon
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY, USA.|Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Vinita
authors.initials: V
authors.lastname: Sehgal
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Leandra
authors.initials: L
authors.lastname: Miko
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Rafael
authors.initials: R
authors.lastname: Khaim
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Benvenisty
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Lerner
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Antonios
authors.initials: A
authors.lastname: Arvelakis
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Vikram
authors.initials: V
authors.lastname: Wadhera
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Ames
authors.affiliation: Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Ron
authors.initials: R
authors.lastname: Shapiro
mesh_terms: D000069594:Abatacept / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D065095:Calcineurin Inhibitors / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000188:drug therapy* / Q000209:etiology; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D000069594:Abatacept
keywords: HIV; belatacept; delayed graft function; immunosuppression; kidney transplantation