Three-Year Outcomes in Kidney Transplant Recipients Switched From Calcineurin Inhibitor-Based Regimens to Belatacept as a Rescue Therapy Article Swipe
Antoine Morel
,
Léa Hoisnard
,
Caroline Dudreuilh
,
Anissa Moktefi
,
David Kheav
,
Ana Pimentel
,
Hamza Sakhi
,
David Mokrani
,
Philippe Attias
,
Karim El Sakhawi
,
C. Champy
,
Philippe Rémy
,
É. Sbidian
,
Philippe Grimbert
,
Marie Matignon
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.3389/ti.2022.10228
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.3389/ti.2022.10228
Background: The long-term benefits of conversion from calcineurin inhibitors (CNIs) to belatacept in kidney transplant recipients (KTr) are poorly documented . Methods: A single-center retrospective work to study first-time CNI to belatacept conversion as a rescue therapy [eGFR <30 ml/min/1.73 m 2 , chronic histological lesions, or CNI-induced thrombotic microangiopathy (TMA)]. Patient and kidney allograft survivals, eGFR, severe adverse events, donor-specific antibodies (DSA), and histological data were recorded over 36 months after conversion. Results: We included N = 115 KTr. The leading cause for switching was chronic histological lesions with non-optimal eGFR (56.5%). Three years after conversion, patient, and death-censored kidney allograft survivals were 88% and 92%, respectively, eGFR increased significantly from 31.5 ± 17.5 to 36.7 ± 15.7 ml/min/1.73 m 2 ( p < 0.01), the rejection rate was 10.4%, OI incidence was 5.2 (2.9–7.6) per 100 person-years. Older age was associated with death, eGFR was not associated with death nor allograft loss. No patient developed dn DSA at M36 after conversion. CNI-induced TMA disappeared in all cases without eculizumab use. Microvascular inflammation and chronic lesions remained stable. Conclusion: Post-KT conversion from CNIs to belatacept, as rescue therapy, is safe and beneficial irrespective of the switch timing and could represent a good compromise facing organ shortage. Age and eGFR at conversion should be considered in the decision whether to switch.
Related Topics
Concepts
Medicine
Belatacept
Calcineurin
Urology
Kidney transplantation
Internal medicine
Thrombotic microangiopathy
Kidney
Surgery
Transplantation
Kidney transplant
Disease
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3389/ti.2022.10228
- OA Status
- gold
- Cited By
- 10
- References
- 45
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4229444525
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4229444525Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3389/ti.2022.10228Digital Object Identifier
- Title
-
Three-Year Outcomes in Kidney Transplant Recipients Switched From Calcineurin Inhibitor-Based Regimens to Belatacept as a Rescue TherapyWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2022Year of publication
- Publication date
-
2022-04-13Full publication date if available
- Authors
-
Antoine Morel, Léa Hoisnard, Caroline Dudreuilh, Anissa Moktefi, David Kheav, Ana Pimentel, Hamza Sakhi, David Mokrani, Philippe Attias, Karim El Sakhawi, C. Champy, Philippe Rémy, É. Sbidian, Philippe Grimbert, Marie MatignonList of authors in order
- Landing page
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https://doi.org/10.3389/ti.2022.10228Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.3389/ti.2022.10228Direct OA link when available
- Concepts
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Medicine, Belatacept, Calcineurin, Urology, Kidney transplantation, Internal medicine, Thrombotic microangiopathy, Kidney, Surgery, Transplantation, Kidney transplant, DiseaseTop concepts (fields/topics) attached by OpenAlex
- Cited by
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10Total citation count in OpenAlex
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2025: 3, 2024: 4, 2023: 2, 2022: 1Per-year citation counts (last 5 years)
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45Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.eGFR | 91, 108, 145, 209 |
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