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Belatacept Conversion in Kidney Recipients with Low GFR Does Not Improve Renal Function.

D. Abdelwahab,1 S. Byron,2 B. Kaplan,1 R. Heilman.1

1Transplant, Mayo Clinic, Scottsdale, AZ
2Biostatistics and Informatics, Mayo Clinic, Rochester, MN

Meeting: 2017 American Transplant Congress

Abstract number: 517

Keywords: Graft function, Graft survival, Immunosuppression

Session Information

Session Name: Concurrent Session: Kidney General Outcomes

Session Type: Concurrent Session

Date: Tuesday, May 2, 2017

Session Time: 4:30pm-6:00pm

 Presentation Time: 4:42pm-4:54pm

Location: E354a

Background:

Belatacept interferes with signal 2 of T cell activation via blockade CD80/86 which doesn't adversely impact renal function. We tested a hypothesis that Belatacept conversion might improve GFR in kidney transplant patients with low GFR. We used propensity matching to select the control group. To our knowledge this is the first study which compared the Belatacept recipients to a matched control cohort on tacrolimus regimen.Methods:Matched control single center retrospective study of all kidney recipients converted from CNI to Belatacept during period 1/2012-9/2016. Exclusion criteria: EBV negative and positive DSA (MFI>5000). Propensity matching for age, sex, race, KDPI, DGF, donor source, eGFR at conversion, baseline biopsy cv score and compared their outcomes 4 months post-conversion. Continuous data was tested via paired t-test. Categorical data was tested using McNemar's test. .Results:31 patients were converted from tacrolimus to Belatacept were compared to a paired matched control. There was no difference in the change of eGFR at 4 months in the bela and control group(see the table). There was no significant difference in rejection rate, denovo DSA and graft survival between the groups. Conclusions:. We found no evidence belatacept conversion improves eGFR 4 months after conversion in kidney transplant recipients with low eGFR.

variable belatacept control difference p
time-0 GFR 23.3±12.3 26.73±12.61 -3.43(4) 0.282
4-month GFR 32.67±17.1 33.82±13.74 -1.15(19) 0.775
age 54.29(12.3) 55.35(12.04) -1.06(5) 0.733
gender (%) 13(42) 12(39) 1(35) 1
Afro-American Recipient(%) 2(6) 1(3) 1(3) 1
living donor(%) 6(19) 7(23) 5(16) 1
acute rejection (%) 6(20) 6(20) 6(20) 1
de novo DSA %) 12(41) 6(21) 12(41) 0.15
dGFR 9.07(14.45) 6.91(9.89) 2.16(18) 0.5032

CITATION INFORMATION: Abdelwahab D, Byron S, Kaplan B, Heilman R. Belatacept Conversion in Kidney Recipients with Low GFR Does Not Improve Renal Function. Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Abdelwahab D, Byron S, Kaplan B, Heilman R. Belatacept Conversion in Kidney Recipients with Low GFR Does Not Improve Renal Function. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/belatacept-conversion-in-kidney-recipients-with-low-gfr-does-not-improve-renal-function/. Accessed May 12, 2025.

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