Temporal trends and current use of de novo belatacept in kidney transplant recipients in the United States.

Autor: Karadkhele G; Emory Transplant Center, Department of Surgery, Emory School of medicine, Atlanta, Georgia, USA., Duneton C; Emory Transplant Center, Department of Surgery, Emory School of medicine, Atlanta, Georgia, USA.; Pediatric Nephrology Department, Robert Debré Hospital, APHP, Paris, France., Garro R; Pediatric Nephrology Division, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Badell IR; Emory Transplant Center, Department of Surgery, Emory School of medicine, Atlanta, Georgia, USA., Pearson TC; Emory Transplant Center, Department of Surgery, Emory School of medicine, Atlanta, Georgia, USA., Larsen CP; Emory Transplant Center, Department of Surgery, Emory School of medicine, Atlanta, Georgia, USA., Hogan J; Emory Transplant Center, Department of Surgery, Emory School of medicine, Atlanta, Georgia, USA.; Pediatric Nephrology Department, Robert Debré Hospital, APHP, Paris, France.
Jazyk: angličtina
Zdroj: Clinical transplantation [Clin Transplant] 2022 Mar; Vol. 36 (3), pp. e14531. Date of Electronic Publication: 2021 Nov 29.
DOI: 10.1111/ctr.14531
Abstrakt: The adoption of de novo belatacept in kidney transplant (kTx) recipients was hampered by an increased risk of acute cellular rejection (ACR) with variation in adopted belatacept based immunosuppressive therapies across centers. We used data from the Scientific Registry of Transplant Recipients (SRTR) to evaluate the temporal trends in belatacept use and describe the associated induction and maintenance regimens in US adult kTx recipients transplanted between June 2011 and December 2018. The number of patients receiving de novo-belatacept based immunosuppressive therapy increased from .74% in 2011 to 3.11% in 2016. In 2016, 66/207 centers used de novo belatacept-based regimen with 3.03% using it in over 50% of their patients. The use of T-cell depleting agents increased with time. Since 2012, the rate of calcineurin inhibitor (CNI) use in combination with belatacept remained stable around 50% and ∼30% remained under belatacept/CNI combination at 1-year post-transplantation. The adoption of belatacept as de novo immunosuppressive regimen has been slow and its use remains low in the United States. Various regimens have been used to modulate the risk of ACR. Further studies evaluating the long-term outcomes of these regimens and assessing their safety especially with regard to the risk of infection are needed.
(© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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