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Clin Transplant. 2017 Sep;31(9). doi: 10.1111/ctr.13042. Epub 2017 Jul 21.

Retrospective evaluation of the efficacy and safety of belatacept with thymoglobulin induction and maintenance everolimus: A single-center clinical experience.

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Division of Nephrology, Massachusetts General Hospital, Boston, MA, USA.
Division of Nephrology, University of California San Francisco, San Francisco, CA, USA.
Division of Transplant Surgery, University of California San Francisco, San Francisco, CA, USA.


Belatacept use has been constrained by higher rates of acute rejection. We hypothesized that belatacept with low-dose rATG and initial mycophenolate maintenance with conversion to everolimus at 1 month post-transplant ± corticosteroids would improve efficacy and maintain safety. Retrospective single-center analysis of the first 44 low immunologic risk kidney transplant recipients treated with this regimen. The cohort was 59% male, mean age at transplant of 57 years. Diabetes was the most common cause of ESRD (39%). The mean 1-year eGFR was 61.4 (SD 18.4) mL/min/1.73 m2 . There were five acute cellular rejections (11.4%) that occurred in patients who had changed from everolimus to mycophenolate mofetil due to side effects. Thirty-two percent developed BK viremia and 12% developed CMV viremia. There were no cases of PTLD. A novel belatacept regimen with rATG induction and maintenance everolimus demonstrated a low acute rejection rate and maintained an excellent 1-year eGFR.


Fusion proteins: belatacept, immunosuppressant; Immunosuppressant; mechanistic target of rapamycin: everolimus, immunosuppressive regimens

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