Date: Tuesday, June 14, 2016
Session Name: Poster Session D: Kidney Immunosuppression: Novel Agents
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: The presence of donor-specific antibodies (DSA) has been associated with an increased risk of antibody-mediated rejection and graft failure. Mean fluorescence intensity (MFI) is a semi-quantitative measure of the level of DSAs in a recipient's circulation. The level of MFI in the subset of BENEFIT study participants who developed de novo DSAs was examined.
Methods: Recipients of living or standard criteria deceased donor kidneys were randomized to receive belatacept more intense (MI)-based, belatacept less intense (LI) -based, or cyclosporine A (CsA)-based immunosuppression. The presence of de novo DSAs was assessed in all randomized, transplanted patients at baseline; at Months 6, 12, 24, 36, 48, 60, 84; and at the time of any clinically suspected episodes of acute rejection. Antibody screening was performed centrally at Emory University using solid phase flow cytometry (FlowPRA™). Samples from all DSA-positive patients were further tested with Luminex® single antigen bead assays (One Lambda, Inc). Patients were scored as follows: MFI >2000 was considered positive and MFI <2000 as negative.
Results: At 5 years post-transplant, MFI in de novo DSA-positive belatacept-treated patients was lower than that of de novo DSA-positive CsA-treated patients. By 7 years post-transplant, 1.4% (3/219) of belatacept MI-treated, 3.1% (7/226) of belatacept LI-treated, and 11.6% (25/215) of CsA-treated patients had developed de novo DSAs. By Kaplan-Meier analysis, the incidence of de novo DSAs was statistically significantly lower in belatacept-treated vs. CsA-treated patients over 7 years of follow-up (P<.0001). Updated 7-year MFI results will be presented at the meeting.
Conclusions: Belatacept-based immunosuppression seems to be associated with a lower incidence of de novo DSAs and, in those who develop de novo DSAs, lower MFI vs. CsA-based immunosuppression.
CITATION INFORMATION: Bray R, Gebel H, Townsend R, Polinsky M, Yang L, Meier-Kriesche U, Larsen C. Reduced Incidence and Level of De Novo Donor-Specific Antibodies in Belatacept-Treated vs. Cyclosporine-Treated Patients: Final Results from BENEFIT. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Bray R, Gebel H, Townsend R, Polinsky M, Yang L, Meier-Kriesche U, Larsen C. Reduced Incidence and Level of De Novo Donor-Specific Antibodies in Belatacept-Treated vs. Cyclosporine-Treated Patients: Final Results from BENEFIT. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/reduced-incidence-and-level-of-de-novo-donor-specific-antibodies-in-belatacept-treated-vs-cyclosporine-treated-patients-final-results-from-benefit/. Accessed April 2, 2020.
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