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Tissue Talks: Graft´s Histological Findings 10 Years after Belatacept or CNI

G. Mondragon-Ramirez,1 N. Uribe-Uribe,2 J. Arreola-Guerra,5 R. Reyes-Acevedo,5 M. Vilatoba,3 J. Furuzawa-Carballeda,4 A. Lopez-Toledo,1 G. Mondragon-Salgado,1 J. Alberu.3

1Inst Mex de Trasplantes, Cuernavaca, Mexico
2Pathology, Inst Nal de C. Médicas y Nutrición SZ, Mexico City, Mexico
3Transplantation, Inst Nal de C. Médicas y Nutrición SZ, Mexico City, Mexico
4Immunology, Inst Nal de C. Médicas y Nutrición SZ, Mexico City, Mexico
5Transplantation, C Hospital Miguel Hidalgo, Aguascalientes, Mexico.

Meeting: 2018 American Transplant Congress

Abstract number: 122

Keywords: Biopsy, Immunosuppression, Kidney transplantation, Outcome

Session Information

Date: Sunday, June 3, 2018

Session Name: Concurrent Session: Kidney Immunosuppression: Co-Stimulation Based Regimens

Session Time: 4:30pm-6:00pm

 Presentation Time: 5:30pm-5:42pm

Location: Room 6C

Related Abstracts
  • Immunophenotype of Cells Infiltrating the Graft Explains the Benefits of Belatacept
  • Long-Term Belatacept Exposure Maintains Efficacy and Safety at 5 Years: Results from the Long-Term Extension (LTE) of the Belatacept Evaluation of Nephroprotection and Efficacy as First-Line Immunosuppression Trial (BENEFIT) Study

The BENEFIT study demonstrated that 7 yrs after kidney transplantation (KT), mean eGFR, patient and graft survival, were significantly higher in the belatacept group than in the cyclosporine group. No data on morphological changes at long-term f-u for patients included in the study is available. This trial analyses graft histological changes 1 decade after KT in groups of patients who continue on belatacept (bela, n=23), cyclosporine (CsA, n=7) or were switched from bela to Tacrolimus (Tac, n=3) during the first months post-KT. Patients and Methods: Thirty-three adults, functionally stable KTR, accepted and signed an informed consent for graft biopsy (Bxs) performance. Bxs were blindly analyzed, and scored according to Banff 2013 by a nephropathologist. Results are depicted in Table 1; CsA and Tac patients were grouped as CNI; eGFR (MDRD4) is indicated.

Variables Bela CNI P value
KT to graft Bx (yrs) 10.1 (0.2) 10.1 (0.2) 0.50
SCr, m (SD) 0.91 (0.2) 1.52 (0.96) <0.01
eGFR, m (SD) 86.4 (17.7) 61 (19.9) <0.01
Acute rej, n (%) 1 ACR (4.3) 3 AMR (30) 0.07
Borderline, n (%) 3 (30) 9 (39.1) 0.71
Tubulitis* 0.47 (0-1) 0.7 (0-2) 0.30
Int. Infl.* 0.13 (0-1) 0.5 (0-1) 0.02
Glomerulitis* 0.08 (0-1) 0.44 (0-2) 0.0.5
PTC* 0 0.5 (0-2) <0.01
C4d, n (%) 0 2 (25) 0.46
Hialinosis* 1.1 (0-2) 2.1 (0-3) 0.01
V* 0 0
IFTA* 10 (0-20) 25 (10-60) <0.01
CG* 0 0.1 (0-1) 1.0
IF* 0.6 (0-2) 1.5 (1-3) <0.01
TA* 0.52 (0-1) 1.3 (0-3) <0.01
CV* 0.56 (0-2) 1.5 (0-3) <0.01
MM* 0.9 (0-3) 0.9 (0-3) 0.97
* m (min-max)

Conclusions: Despite the limited number of patients, the findings show an overall significantly lower acute inflammation and scarring (IFTA) for KTR under bela compared to CNI. The higher preserved graft function observed in BENEFIT could be attributed to these findings.

CITATION INFORMATION: Mondragon-Ramirez G., Uribe-Uribe N., Arreola-Guerra J., Reyes-Acevedo R., Vilatoba M., Furuzawa-Carballeda J., Lopez-Toledo A., Mondragon-Salgado G., Alberu J. Tissue Talks: Graft´s Histological Findings 10 Years after Belatacept or CNI Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Mondragon-Ramirez G, Uribe-Uribe N, Arreola-Guerra J, Reyes-Acevedo R, Vilatoba M, Furuzawa-Carballeda J, Lopez-Toledo A, Mondragon-Salgado G, Alberu J. Tissue Talks: Graft´s Histological Findings 10 Years after Belatacept or CNI [abstract]. https://atcmeetingabstracts.com/abstract/tissue-talks-grafts-histological-findings-10-years-after-belatacept-or-cni/. Accessed March 8, 2021.

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