Presence of Chronic Vascular Lesions on Allograft Biopsy is Associated with Greater Improvement in Renal Function after Conversion from Tacrolimus to Belatacept
1Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
2Servicio de Nefrologia, Hospital del Mar, Barcelona, Spain
3Pharmacy Services, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Meeting: 2018 American Transplant Congress
Abstract number: C93
Keywords: Calcineurin, Co-stimulation, Immunosuppression, Kidney transplantation
Session Information
Session Name: Poster Session C: Kidney Immunosuppression: Novel Regimens and Drug Minimization
Session Type: Poster Session
Date: Monday, June 4, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background: Conversion from tacrolimus to belatacept has been shown to be beneficial for an increasing number of kidney transplant (KT) patients. However, predicting factors for favorable outcomes after the conversion are still unknown. We aimed to investigate if the histological findings, in particular vascular lesions, at the time of conversion might predict a greater improvement in renal function 12 months after the conversion.
Methods: This is a single center retrospective study of 20 KT patients who were converted from tacrolimus to belatacept after KT. All patients underwent an allograft biopsy prior to conversion. We analyzed the evolution of the estimated glomerular filtration rate (eGFR) at 12 months after conversion.
Results: Mean age was 49.5 years and 65% of them were male. Median time to conversion was 3 [2-16] months post-transplantation, with a median follow-up time of 30 months. 45% of the patients had moderate to severe chronic vascular lesions (cv2-3) on biopsy prior to conversion. We observed an increase in eGFR from 38.3 to 48.3 ml/min 12 months after conversion in the whole cohort (p=0.042). Five patients suffered from acute rejection after the conversion although none of them resulted in graft loss. No serious infections or neoplasias were noticed during the follow-up. Patients with cv2-3 prior to conversion (n=9) presented a higher increase in eGFR (34.4 to 49.6 ml/min) at 12 months compared to those who did not have these lesions (n=11, 42.7 to 47.1 ml/min).
Conclusions: Conversion from tacrolimus to belatacept seems to be safe and has a beneficial effect in terms of renal function in KT patients. Patient with chronic vascular lesions in the biopsy prior to conversion have 3-fold greater improvement in renal function when compared to those without vascular lesions.
CITATION INFORMATION: Perez-Saez M., Yu B., Uffing A., Murakami N., Azzi J., El Haji S., Gabardi S., Riella L. Presence of Chronic Vascular Lesions on Allograft Biopsy is Associated with Greater Improvement in Renal Function after Conversion from Tacrolimus to Belatacept Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Perez-Saez M, Yu B, Uffing A, Murakami N, Azzi J, Haji SEl, Gabardi S, Riella L. Presence of Chronic Vascular Lesions on Allograft Biopsy is Associated with Greater Improvement in Renal Function after Conversion from Tacrolimus to Belatacept [abstract]. https://atcmeetingabstracts.com/abstract/presence-of-chronic-vascular-lesions-on-allograft-biopsy-is-associated-with-greater-improvement-in-renal-function-after-conversion-from-tacrolimus-to-belatacept/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress