*Purpose: This study aimed to describe the outcomes, stratified by race, associated with belatacept and sirolimus immunosuppression after alemtuzumab induction.

*Methods: This was a retrospective, single-center study analyzing the outcomes of kidney transplant recipients who received belatacept-sirolimus after alemtuzumab induction. To be included, patients must have received a kidney-only transplant between 1/1/2016 and 8/31/2019, be >/= 18 years old, and be EBV seropositive. The primary outcome was renal function (GFR by MDRD or CKD-EPI) at 1 year. Secondary outcomes were renal function at 3, 6, and 9 months, incidence of biopsy proven rejection (BPAR), patient/graft survival, incidence of infection and malignancy, and medication tolerability.

*Results: Fifteen African American (AA) and 26 non-AA patients were included. The cohorts were well-matched, except for more deceased donor recipients and longer cold ischemic times in the AA cohort (see figure 1). At 1 year, median GFR was 60 mL/min in the AA cohort and 55.5 mL/min in the non-AA cohort (p=0.82) (see figures 2 and 3). Patient/graft survival was 100% overall. BPAR occurred in 3 patients (20%) in the AA group, 1 due to non-adherence and 1 to a decrease in immunosuppression due to BK viremia. No BPAR was seen in the non-AA group. Mouth ulcers and leukopenia were the most common ADRs (40% vs 46.2% and 20% vs 53.8%, respectively). Infection rates were similar between groups with CMV (6 patients in each) and BK viremia (3 vs 1 patient, respectively).

*Conclusions: No significant differences between the AA and non-AA cohort were found in GFR at 1 year. Rejection occurred in 20% of patients, which is similar to prior studies with belatacept. The medication regimen was well tolerated with excellent patient/graft survival. In conclusion, race did not impact renal outcomes in patients who received this belatacept-based regimen.

« Back to 2021 American Transplant Congress