ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Advanced Search

Case Series of Belatacept for Calcineurin Inhibitor Sparing after Lung Transplantation

H. Patel, C. R. Ensor, R. D. Davis, L. Bogar, D. Colella, M. Kildea, J. Kim, A. Satterthwaite, D. Ventura, C. Gries

AdventHealth, Orlando, FL

Meeting: 2020 American Transplant Congress

Abstract number: C-310

Keywords: Immunosuppression, Lung, Lung transplantation, Rejection

Session Information

Date: Saturday, May 30, 2020

Session Name: Poster Session C: Lung: All Topics

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

Related Abstracts
  • Successful Maintenance Belatacept-Based Immunosuppression in Lung Transplantation Recipients Who Failed Calcineurin Inhibitors.
  • Belatacept Conversion for Calcineurin Inhibitor-Associated Thrombotic Microangiopathy in Kidney Transplant Recipients

*Purpose: Belatacept is a recombinant soluble fusion protein which selectively blocks T-cell co-stimulation. It received initial FDA approval for prophylaxis of organ rejection in Epstein-Barr virus seropositive kidney transplant recipients. Use of belatacept for prophylaxis of rejection in other transplanted organs has not been well established. Data from a limited number of small studies suggest a possible role of belatacept among lung transplant recipients (LTR).

*Methods: We report a case series on the use of belatacept in LTRs at a single comprehensive transplant center. Descriptive statistics were used to describe patient characteristics and univariate nonparametric statistical tests were used to assess differences before and after belatacept.

*Results: A total of twenty-three patients received belatacept as a calcineurin inhibitor (CNI) sparing or dose reducing strategy. Four patients were initiated on belatacept-based immunosuppression regimen (ISR) immediately after LT due to pre-lung transplant renal impairment. Indications for belatacept included CNI-associated renal impairment in 10/23 (43%) LTRs, CNI-associated thrombotic microangiopathy in 3/23 (13%) LTRs, CNI-associated stroke in 2/23 (7%) LTRs, and CNI-associated posterior reversible encephalopathy syndrome in 4/23 (17%) LTRs. Within the two-year study period, 15/23 (65%) LTRs were transitioned back to CNI or had addition of CNI to their ISR. Statistically significant increase in mean glomerular filtration rate (GFR) was seen in all patients with pre-belatacept mean GFR 52ml-min/m2 versus post-belatacept mean GFR 85ml-min/m2, p < 0.001 using two tailed Man Whitney U. All five patients who needed post-operative dialysis were liberated from dialysis at discharge and remained dialysis free throughout the 2-year study period. No patients experienced belatacept-treatment limiting adverse events or cellular rejection (average CRSS while on belatacept = 0.184). Fifteen positive bronchoalveolar lavage cultures were identified, consisting of 4/15 (27%) gram positive cultures and 11/15 (73%) gram negative cultures. Four patients died while on belatacept attributed to chronic lung allograft dysfunction in 3/4 (75%) LTRs and multiorgan system failure in the fourth patient.

*Conclusions: Belatacept-based ISRs seems to be a reasonable option for LTRs with contraindication to or intolerance to CNI. Larger trials are needed to establish the effectiveness of belatacept in LTRs.

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Patel H, Ensor CR, Davis RD, Bogar L, Colella D, Kildea M, Kim J, Satterthwaite A, Ventura D, Gries C. Case Series of Belatacept for Calcineurin Inhibitor Sparing after Lung Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/case-series-of-belatacept-for-calcineurin-inhibitor-sparing-after-lung-transplantation/. Accessed March 6, 2021.

« Back to 2020 American Transplant Congress

Most Viewed Abstracts

  • This Week
  • This Month
  • All Time
  • Role of Mitochondria, Metabolism and Inflammation: Pathways Influencing Short Term Outcomes Post-Renal Transplantation
    • Factors Influencing Creatinine Rise Following Donor Nephrectomy

    Visit Our Partner Sites

    American Transplant Congress (ATC)

    Visit the official site for the American Transplant Congress »

    American Journal of Transplantation

    The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

    American Society of Transplantation (AST)

    An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

    American Society of Transplant Surgeons (ASTS)

    The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

    Copyright © 2013-2021 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

    Privacy Policy

    loading Cancel
    Post was not sent - check your email addresses!
    Email check failed, please try again
    Sorry, your blog cannot share posts by email.
    This site uses cookies: Find out more.