Belatacept-based, ATG-Fresenius-induction regimen for kidney transplant recipients: A proof-of-concept study
| Autor: | Javier Roberti, Federico Cicora, Liliana Reniero, Matias Casanova, Fernando Mos, J. Petroni |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Immunoconjugates medicine.medical_treatment Immunology Single Center Belatacept Gastroenterology Mycophenolic acid Abatacept Internal medicine medicine Animals Humans Immunology and Allergy Kidney transplantation Aged Antilymphocyte Serum Transplantation business.industry Immunosuppression Middle Aged Allografts medicine.disease Kidney Transplantation Calcineurin Regimen Methylprednisolone Female Rabbits business Immunosuppressive Agents medicine.drug |
| Zdroj: | Transplant Immunology. 32:35-39 |
| ISSN: | 0966-3274 |
| Popis: | Belatacept provides effective immunosuppression while avoiding the nephrotoxicities associated with calcineurin inhibitors (CNIs). However, existing belatacept-based regimens still have high rates of acute rejection. We hypothesized that therapy with belatacept, mycophenolic acid (MMA), steroids and induction therapy with rabbit anti-thymocyte globulin Fresenius (ATGF), rejection rate could be reduced. Prospective, single center, proof-of-concept study including males and females aged ≥18years, Epstein-Barr virus (EBV)-seropositive recipients of a first, HLA non-identical, live or deceased donor kidney allograft. Only patients with a calculated panel reactive antibody score of 0% were included. Three donors were positive for Chagas disease. Six of twelve patients had at least one infection and five were readmitted to the hospital for treatment. One patient had a Trypanosoma cruzi infection via the graft treated successfully. Median cold ischemia time for the transplant patients with a deceased donor was 21.5h. Mean serum creatinine levels at 1, 3 and 6months were 1.76±0.59, 1.55±0.60 and 1.49±0.60mg/dl, respectively. Two of twelve patients experienced clinical, biopsy-proven rejection, successfully treated with methylprednisolone. No patient developed post-transplant lymphoproliferative disorder (PTLD) or any other malignancy and no patient lost their graft or died during follow-up. The potential of this approach makes it worthy of further investigation. |
| Databáze: | OpenAIRE |
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