Belatacept offers a new option for renal allograft recipients who are suffering from side effects of calcineurin inhibitor or mTOR. Such a conversion may result in renal and extrarenal benefits. Today the effect of this new immunosuppressant on the immunophenotype is largely unknown. Therefore we prospectively performed flow cytometric immunophenotyping of especially T-helper cells. In total we were able to fully investigate a potential immunophenotype change in 5 patients after CNI withdrawal (n=3) or conversion from mTOR to Belatacept (n=2). Stable clinical courses were observed in the patients and no rejection episodes occurred. Cells were analyzed at time points pre conversion, 1 month, 3 months, 6 months and 12 months post conversion. The percentage of central memory, naïve, effector memory and terminally differentiated effector memory CD4+ T-cells was determined. CD28, CD25, CD69 and CD71 expression on CD4+ T-cells were measured ex vivo and also after 3 days of ConcanavalinA stimulation. Additionally intracellular cytokines IFNgamma and IL-2 were measured after PMA/Ionomycin cell stimulation. The expression of activation markers and intracellular cytokines as well as the percentage of T-helper cell subsets did not change during the observation period. Therefore the conversion of CNI or mTOR to belatacept seems to have no impact on the immunophenotype of CD4+ T-cells in patients after kidney transplantation.

« Back to 2015 American Transplant Congress