Early post-transplant conversion from tacrolimus to belatacept for prolonged delayed graft function improves renal function in kidney transplant recipients

David Wojciechowski, Sindhu Chandran, Flavio Vincenti

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Prolonged delayed graft function (DGF) in kidney transplant recipients imparts a risk of poor allograft function; tacrolimus may be detrimental in this setting. We conducted a retrospective single center analysis of the first 20 patients converted to belatacept for prolonged DGF as part of a clinical protocol as a novel treatment strategy to treat prolonged DGF. Prior to conversion, patients underwent an allograft biopsy to rule out rejection and confirm tubular injury. The primary outcome was the estimated glomerular filtration rate (eGFR) at 12 months post-transplant; secondary outcome was the change in eGFR 30 days post-belatacept conversion. At 1 year post-transplant, the mean eGFR was 54.2 (SD 19.2) mL/min/1.73 m2. The mean eGFR on the day of belatacept conversion was 16 (SD 12.7) mL/min/1.73 m2 and rose to 43.1 (SD 15.8) mL/min/1.73 m2 30 days post-conversion (P<.0001). The acute rejection rate was 20% with 100% patient survival at 12 months post-transplant. There was one graft loss in the setting of an invasive Aspergillus infection that resulted in withdrawal of immunosuppression and transplant nephrectomy. Belatacept conversion for prolonged DGF is a novel treatment strategy that resulted in an improvement in eGFR. Additional follow-up is warranted to confirm the long-term benefits of this strategy.

Original languageEnglish (US)
Article numbere12930
JournalClinical Transplantation
Volume31
Issue number5
DOIs
StatePublished - May 2017
Externally publishedYes

Keywords

  • belatacept
  • delayed graft function
  • kidney transplant

ASJC Scopus subject areas

  • Transplantation

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