Belatacept in Kidney Transplant Recipients with Preformed Donor Specific Anti-HLA Antibodies: Results of the BELACOR Trial
1Nephrology Transplantation, APHP Henri Mondor, Creteil, France
2Public Health, APHP Henri Mondor, Creteil, France
3Nephrology Transplantation, APHP Tenon, Paris, France
4Nephrology Transplantation, APHP Bicêtre, Le Kremlin Bicêtre, France
5Histocompatibility, APHP Saint Louis, Paris, France.
Meeting: 2018 American Transplant Congress
Abstract number: 121
Keywords: Immunosuppression, Kidney transplantation, Rejection
Session Information
Session Name: Concurrent Session: Kidney Immunosuppression: Co-Stimulation Based Regimens
Session Type: Concurrent Session
Date: Sunday, June 3, 2018
Session Time: 4:30pm-6:00pm
Presentation Time: 5:18pm-5:30pm
Location: Room 6C
Introduction
Antibody-mediated rejection (ABMR) is currently a critical question in kidney transplant recipient with immunological risk factors such as pre transplant donor-specific anti HLA antibodies (DSA). Recent phase III clinical studies have shown a significant lower incidence of DSA in patients treated with Belatacept when compared to recipients receiving a conventional immunosuppressive regimen with calcineurin inhibitors (CNI). Potential benefits of Belatacept in kidney transplant recipient with preformed DSA have not yet been determined.
Patients and Methods
Here we present the results of the first multicenter prospective clinical trial aiming to determine allograft outcome after kidney transplant recipients treated with de novo Belatacept and exhibiting a mild immunological risk defined by the presence of preformed DSA with mean fluorescence intensity (MFI) between 500 and 3000 (Luminex). Primary objective was the incidence of clinical and subclinical ABMR at month 12 (M12).
Results
51 patients from 3 French kidney transplant centers (Paris) were included in the BELACOR trial between 2014 and 2016. DSA Maximal Fluorescence Intensity (MFImax) detected within one year prior transplant was 1340 ±742 for class I DSA and 1247 ± 704 for class II DSA. All included recipients received induction therapy with Thymoglobulin. Maintenance immunosuppression included Belatacept, Mycophenolate Mofetil and Corticosteroids.
Mean donors and recipient age were 50.5 ± 14.7 and 57.5 ±16.2, respectively. No patients exhibited clinical or subclinical ABMR in either kidney allograft for cause or protocol biopsies performed at M3 and M12 (0%, [0-7.25%]). Patient and allograft survival at one year was 100% and 92%, respectively. Incidence of acute T-cell mediated rejection was 25.4%. Mean estimated glomerular filtration rate at the end of follow up was 53.2 ml/min. Class I MFI of preformed DSA significantly decreased between day of transplant and M12 (p= 0.02).
Conclusion
Belatacept prevent the occurrence of ABMR in kidney transplant recipients with preformed DSA.
CITATION INFORMATION: Leibler C., Canoui F., Matignon M., Rondeau E., Zarour A., Durrbach A., Malard S., Grimbert P. Belatacept in Kidney Transplant Recipients with Preformed Donor Specific Anti-HLA Antibodies: Results of the BELACOR Trial Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Leibler C, Canoui F, Matignon M, Rondeau E, Zarour A, Durrbach A, Malard S, Grimbert P. Belatacept in Kidney Transplant Recipients with Preformed Donor Specific Anti-HLA Antibodies: Results of the BELACOR Trial [abstract]. https://atcmeetingabstracts.com/abstract/belatacept-in-kidney-transplant-recipients-with-preformed-donor-specific-anti-hla-antibodies-results-of-the-belacor-trial/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress