Efficacy and Safety Outcomes of Extended Criteria Donor Kidneys by Subtype: Subgroup Analysis of BENEFIT‐EXT at 7 Years After Transplant

Autor: Philip J. O'Connell, D. Carvalho, Thomas Becker, Ferdinand Muehlbacher, G. Grannas, Christian P. Larsen, Sander Florman, Barbara A. Bresnahan, H. U. Meier-Kriesche, A. Chevaile-Ramos
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Graft Rejection
Male
immunosuppressant
medicine.medical_treatment
030232 urology & nephrology
donors and donation: extended criteria
kidney transplantation/nephrology
030230 surgery
Extended criteria
Expanded Criteria Donor
Kidney Function Tests
0302 clinical medicine
Risk Factors
Immunology and Allergy
Pharmacology (medical)
Kidney
Graft Survival
Immunosuppression
Clinical Science
Middle Aged
Prognosis
Tissue Donors
medicine.anatomical_structure
Original Article
Female
Safety
Immunosuppressive Agents
medicine.drug
Glomerular Filtration Rate
medicine.medical_specialty
Urology
Subgroup analysis
clinical research/practice
Belatacept
Abatacept
03 medical and health sciences
Post-hoc analysis
medicine
Humans
donors and donation: deceased
Transplantation
business.industry
Original Articles
calcineurin inhibitor: cyclosporine A (CsA)
donors and donation: donation after circulatory death (DCD)
Kidney Transplantation
Surgery
Regimen
Kidney Failure
Chronic
business
Follow-Up Studies
Zdroj: American Journal of Transplantation
ISSN: 1600-6143
1600-6135
Popis: The phase III Belatacept Evaluation of Nephroprotection and Efficacy as First‐Line Immunosuppression Trial–Extended Criteria Donors Trial (BENEFIT‐EXT) study compared more or less intensive belatacept‐based immunosuppression with cyclosporine (CsA)–based immunosuppression in recipients of extended criteria donor kidneys. In this post hoc analysis, patient outcomes were assessed according to donor kidney subtype. In total, 68.9% of patients received an expanded criteria donor kidney (United Network for Organ Sharing definition), 10.1% received a donation after cardiac death kidney, and 21.0% received a kidney with an anticipated cold ischemic time ≥24 h. Over 7 years, time to death or graft loss was similar between belatacept‐ and CsA‐based immunosuppression, regardless of donor kidney subtype. In all three donor kidney cohorts, estimated mean GFR increased over months 1–84 for belatacept‐based treatment but declined for CsA‐based treatment. The estimated differences in GFR significantly favored each belatacept‐based regimen versus the CsA‐based regimen in the three subgroups (p < 0.0001 for overall treatment effect). No differences in the safety profile of belatacept were observed by donor kidney subtype.
Irrespective of the type of extended donor kidney transplanted, belatacept‐based immunosuppression is associated with similar death/graft loss and improved renal function at 7 years posttransplant versus cyclosporine‐ based immunosuppression, with no notable differences in the safety profile of belatacept by donor kidney subtype.
Databáze: OpenAIRE
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