Abstract
Belatacept is a novel fusion protein that blocks signal two of T cell activation. Belatacept was approved in 2015 for the prevention of acute rejection in kidney transplant recipients. Results from a 2014 phase II clinical trial in liver transplant recipients was terminated early due to an increased risk of death and graft loss, leading to a black box warning for its use in liver transplant recipients. Here we describe the clinical course of a 55 year old male patient who underwent a liver transplant for cholestatic liver disease. His post-transplant course was complicated by multiple episodes of severe acute cellular rejection as well as multiple complications from maintenance immunosuppression including chronic kidney disease (CKD), steroid-induced diabetes, mycophenolate-associated colitis, and mammalian target of rapamycin (mTOR) inhibitor-induced lung injury. Belatacept was initiated 5 years post-transplant as a last-line option for maintenance immunosuppression. Six months post-initiation, the patient has had stabilization of his CKD, improvement in lung function, and remains without evidence of acute or chronic rejection.
Original language | English (US) |
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Article number | 100070 |
Journal | Transplantation Reports |
Volume | 5 |
Issue number | 4 |
DOIs | |
State | Published - Dec 2020 |
Externally published | Yes |
Keywords
- Acute cellular rejection
- Belatacept
- Chronic kidney disease in liver transplantation
- Immunosuppression
- Immunosuppression related adverse drug reactions
- Liver transplantation
- Mammalian target of rapamycin inhibitor-induced lung injury
- Mycophenolate induced colitis
ASJC Scopus subject areas
- Surgery
- Transplantation