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Conversion to belatacept after lung transplantation: Report of 10 cases

Brugière, Olivier ; Vallée, Alexandre ; Raimbourg, Quentin ; Peraldi, Marie-Noelle ; de Verdière, Sylvie Colin ; Beaumont, Laurence ; Hamid, Abdulmonem ; Zrounba, Mathilde ; Roux, Antoine ; Picard, Clément ; Parquin, François ; Glorion, Matthieu ; Oniszczuk, Julie ; Hertig, Alexandre ; Mal, Hervé ; Bunel, Vincent Câmara, Niels Olsen Saraiva

PloS one, 2023-03, Vol.18 (3), p.e0281492-e0281492 [Periódico revisado por pares]

United States: Public Library of Science

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Título:
Conversion to belatacept after lung transplantation: Report of 10 cases
Autor: Brugière, Olivier ; Vallée, Alexandre ; Raimbourg, Quentin ; Peraldi, Marie-Noelle ; de Verdière, Sylvie Colin ; Beaumont, Laurence ; Hamid, Abdulmonem ; Zrounba, Mathilde ; Roux, Antoine ; Picard, Clément ; Parquin, François ; Glorion, Matthieu ; Oniszczuk, Julie ; Hertig, Alexandre ; Mal, Hervé ; Bunel, Vincent
Câmara, Niels Olsen Saraiva
Assuntos: Abatacept - pharmacology ; Abatacept - therapeutic use ; Asymptomatic ; Belatacept ; Biology and Life Sciences ; Calcineurin inhibitors ; Calcineurin Inhibitors - adverse effects ; Conversion ; Creatinine ; Dosage and administration ; Glomerular filtration rate ; Graft rejection ; Graft Rejection - drug therapy ; Graft Rejection - prevention & control ; Graft Survival ; Health risks ; Humanities and Social Sciences ; Humans ; Immunology ; Immunosuppression ; Immunosuppressive Agents - adverse effects ; Immunotherapy ; Kidney Transplantation - adverse effects ; Life Sciences ; Lung transplantation ; Lung Transplantation - adverse effects ; Lung transplants ; Lungs ; Lymphocytes T ; Medical research ; Medicine and Health Sciences ; Medicine, Experimental ; Patient outcomes ; Patients ; Renal failure ; Renal function ; Syngeneic grafts ; T cells ; Toxicity ; Transplantation ; Transplantation of organs, tissues, etc
É parte de: PloS one, 2023-03, Vol.18 (3), p.e0281492-e0281492
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Competing Interests: The authors have declared that no competing interests exist.
Descrição: Calcineurin inhibitors (CNIs) remain the cornerstone of maintenance immunosuppression (IS) after lung transplantation (LTx), although CNI-related life-threatening toxic effects may occur. Belatacept, a novel immunosuppressant that blocks a T-cell co-stimulation pathway, is a non-nephrotoxic drug indicated as an alternative to CNIs in kidney Tx. In LTx, there are only a few reports of belatacept conversion as a CNI-free or CNI-sparing IS treatment. We reviewed a series of 10 LTx recipients with conversion to a CNI-free belatacept IS regimen within the first year post-LTx (n = 7) or a belatacept/low-dose CNI combination after the first year (n = 3). Use of belatacept was triggered by severe renal failure in 9 patients and under-IS with previous other IS-related toxicities in 1 patient. Mean estimated glomerular filtration rate after starting belatacept significantly improved at 6 months after initiation and at the last-follow-up (p = 0.006, and p = 0.002 respectively). The incidence of recurrent and/or severe acute cellular rejection (ACR) episodes was high in patients with CNI-free belatacept-based IS (n = 4/7). Chronic graft allograft dysfunction developed in 2 of 9 recipients under belatacept IS. Belatacept was stopped in 6 patients because of recurrent/severe ACR (n = 3), recurrent opportunistic infections (n = 1), center modified policy (n = 1), or other cause (n = 1). Early conversion to CNI-free belatacept-based IS improved renal function in this series but was counterbalanced by a high incidence of recurrent ACR, including life-threatening episodes. Other studies are needed to better determine the indications for its use after LTx, possibly with lower immunological risk IS regimens, such as CNI-sparing belatacept.
Editor: United States: Public Library of Science
Idioma: Inglês

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Conversion to belatacept after lung transplantation: Report of 10 cases

United States: Public Library of Science

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