Impact of Donor Age on Three-Year Outcomes in Recipients of Extended Criteria Kidneys Treated with Belatacept vs Cyclosporine in BENEFIT-EXT Trial
Charité
Univ Berlin, Germany
Hosp 12 de Octubre Madrid, Spain
Univ Hosp Nantes, France
Med Univ Vienna, Austria
Med Hochschule Hannover, Germany
Baylor Univ Med Ctr, TX
BMS, NJ
BMS, France
UCSF, CA
Meeting: 2013 American Transplant Congress
Abstract number: 493
Introduction: Belatacept (bela) was associated with improved renal function & similar pt/graft survival & AR rates vs CsA through 3 yrs follow-up in BENEFIT-EXT, the largest trial yet in recipients of extended criteria kidneys.
Methods: BENEFIT-EXT was a phase 3 study of more intensive & less intensive (LI) bela vs CsA. This posthoc analysis examined 3-yr outcomes by donor age with the approved LI regimen vs CsA.
Results: 74 pts received kidneys from donors ≤50 yrs (39 LI, 35 CsA), 130 pts donor age >50-≤60 (64 LI, 66 CsA), 53 pts donor age >60-≤65 (31 LI, 22 CsA), 46 pts donor age >65-70 (20 LI, 26 CsA), & 54 pts donor age ≥70 (20 LI, 34 CsA); donor age was not available for 1 LI & 1 CsA pt. Mean recipient age generally increased with donor age. Pt/graft survival & mean GFR decreased with donor age (Table). Pts receiving kidneys from younger donors tended to have better outcomes with LI vs CsA. Recipients of kidneys from elderly donors tended to have more AR, especially with LI (donor age >65-<70: 35% in LI vs 23% in CsA; donor age ≥70: 25% in LI vs 15% in CsA). Proportion of pts with SAEs (donor age ≤50: 72% LI vs 66% CsA; donor age ≥70: 75% LI vs 85% CsA), and serious infections (donor age ≤50: 33% LI vs 37% CsA; donor age ≥70: 45% LI vs 56% CsA) were comparable between LI & CsA.
Conclusions: Outcomes were better in recipients from younger donors regardless of treatment group. Bela-treated pts from lower aged donors had the best outcomes. Safety for bela LI was comparable across donor age groups. Despite limited sample sizes, this posthoc analysis suggests that renal function is improved with bela LI regardless of donor age.
| Bela LI, n=175 | CsA, n=184 | |
| Pts surviving with functioning graft, n(%), overall ITT | 144(82) | 147(80) |
| Donor age ≤50 | 34(87) | 29(83) |
| >50-≤60 | 57(89) | 57(86) |
| >60-≤65 | 26(84) | 17(77) |
| >65-<70 | 13(65) | 17(65) |
| ≥70 | 13(65) | 26(77) |
| Mean GFR, mL/min, overall ITT | 42 | 32 |
| Donor age ≤50 | 53 | 41 |
| >50-≤60 | 45 | 34 |
| >60-≤65 | 40 | 31 |
| >65-<70 | 31 | 18 |
| ≥70 | 27 | 25 |
| AR, n(%), overall ITT | 33(19) | 29(16) |
| Donor age ≤50 | 5(13) | 6(17) |
| >50-≤60 | 10(16) | 9(14) |
| >60-≤65 | 6(19) | 3(14) |
| >65-<70 | 7(35) | 6(23) |
| ≥70 | 5(25) | 5(15) |
Budde, K.: Grant/Research Support, BMS, Novartis, Other, BMS, Honoraria, Novartis, Honoraria. Blancho, G.: Grant/Research Support, Astellas, Novartis, Other, BMS, Honoraria, Roche, Honoraria. Lehner, F.: Other, BMS, Honoraria, Cons
To cite this abstract in AMA style:
Budde K, Morales J, Blancho G, Muehlbacher F, Lehner F, Rice K, Pupim L, Aigner S, Vincenti F. Impact of Donor Age on Three-Year Outcomes in Recipients of Extended Criteria Kidneys Treated with Belatacept vs Cyclosporine in BENEFIT-EXT Trial [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/impact-of-donor-age-on-three-year-outcomes-in-recipients-of-extended-criteria-kidneys-treated-with-belatacept-vs-cyclosporine-in-benefit-ext-trial/. Accessed November 22, 2024.« Back to 2013 American Transplant Congress