ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 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
    • 2021 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
  • Search

Early Experience with 4-drug Maintenance Immunosuppression in Kidney and Pancreas Transplant Recipients

S. Mouawad1, C. Shoemaker2, J. Geyston3, A. Nishio Lucar3

1University of Virginia Health System, Charlottesville, VA, 2Pharmacy, UVA Health, Charlottesville, VA, 3University of Virginia, Charlottesville, VA

Meeting: 2022 American Transplant Congress

Abstract number: 1707

Keywords: Graft function, Immunosuppression, Kidney, Outcome

Topic: Clinical Science » Kidney » 38 - Kidney Immunosuppression: Novel Regimens and Drug Minimization

Session Information

Session Name: Kidney Immunosuppression: Novel Regimens and Drug Minimization

Session Type: Poster Abstract

Date: Tuesday, June 7, 2022

Session Time: 7:00pm-8:00pm

 Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Belatacept based immunosuppression regimens in kidney transplant recipients have been associated with better kidney function, improved metabolic profile, less de novo DSA formation and improved preformed DSA at the expense of a higher risk of acute rejection. The transient addition of tacrolimus to de novo Belatacept, mycophenolate and steroids regimen, appears to reduce the risk of rejection without apparent increased risk of BK or CMV viremia.

*Methods: We sought to retrospectively evaluate the safety and early outcomes (6-month follow-up) of adult kidney, pancreas and kidney pancreas recipients undergoing conversion from standard immunosuppression to a 4-drug regimen consisting of belatacept, steroids, mycophenolate or azathioprine and calcineurin inhibitors at a single transplant center.

*Results: We identified 18 transplant recipients (16 kidney, 1 pancreas and 1 kidney-pancreas) with a mean age of 42±15 years. 27.8% were female, 44.4% black race and 22.2% CMV-high risk. Most donors were deceased (88.9%) with a mean KDPI 38±27. All patients were induced with anti-thymocyte globulin. Most common indication for quadruple regimen was tacrolimus intolerance (44.4%). Median time to quadruple regimen initiation from transplant was 201 days (IQR 96-1068). All patients received a belatacept maintenance dose of 5mg/kg every 28 days. The mean eGFR was 46.2±24.9ml/min before and 55.4±22.8 ml/min 6-months after 4-drug regimen initiation (p=0.04). Tacrolimus level at 1 month post initiation was 6.5±2.8 ng/mL and 4.2±2.2 ng/mL by 6 months. No patient had acute rejection and all allografts were functioning at 6 months. The incidence of CMV viremia and BK viremia were 11% for each. No cases of PTLD or EBV viremia were reported.

*Conclusions: Our study illustrates the early 6-month outcomes and safety of belatacept based 4-drug maintenance immunosuppression regimen. There was evidence of eGFR improvement at 6 months and limited incidence of viral infections. Longer follow up and prospective randomized trials are needed to confirm these results.

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Mouawad S, Shoemaker C, Geyston J, Lucar ANishio. Early Experience with 4-drug Maintenance Immunosuppression in Kidney and Pancreas Transplant Recipients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/early-experience-with-4-drug-maintenance-immunosuppression-in-kidney-and-pancreas-transplant-recipients/. Accessed May 8, 2025.

« Back to 2022 American Transplant Congress

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 © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences