Academic Journal
Utility of a fusion protein T‐cell co‐stimulation blocker Belatacept in heart transplant recipients: Real world experience from a high volume center
| العنوان: | Utility of a fusion protein T‐cell co‐stimulation blocker Belatacept in heart transplant recipients: Real world experience from a high volume center |
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| المؤلفون: | Oren, Daniel, Uriel, Matan, Moeller, Cathrine M., Valledor, Andrea Fernandez, DeFilippis, Ersilia M., Lotan, Dor, Colombo, Paolo C., Yuzefpolskaya, Melana, Topkara, Veli K., Clerkin, Kevin J., Raikhelkar, Jayant K., Fried, Justin A., Oh, David (Kyung Taek), Bae, David, Lin, Eddie, Theodoropoulos, Kleanthis, Naka, Yoshifumi, Takeda, Koji, Choe, Jason, Jennings, Douglas L., Majure, David, Latif, Farhana, Sayer, Gabriel, Uriel, Nir |
| المصدر: | Clinical Transplantation ; volume 38, issue 3 ; ISSN 0902-0063 1399-0012 |
| بيانات النشر: | Wiley |
| سنة النشر: | 2024 |
| المجموعة: | Wiley Online Library (Open Access Articles via Crossref) |
| الوصف: | Background Belatacept (BTC), a fusion protein, selectively inhibits T‐cell co‐stimulation by binding to the CD80 and CD86 receptors on antigen‐presenting cells (APCs) and has been used as immunosuppression in adult renal transplant recipients. However, data regarding its use in heart transplant (HT) recipients are limited. This retrospective cohort study aimed to delineate BTC's application in HT, focusing on efficacy, safety, and associated complications at a high‐volume HT center. Methods A retrospective cohort study was conducted of patients who underwent HT between January 2017 and December 2021 and subsequently received BTC as part of their immunosuppressive regimen. Twenty‐one HT recipients were identified. Baseline characteristics, history of rejection, and indication for BTC use were collected. Outcomes included renal function, graft function, allograft rejection and mortality. Follow‐up data were collected through December 2023. Results Among 776 patients monitored from January 2017 to December 2021 21 (2.7%) received BTC treatment. Average age at transplantation was 53 years (± 12 years), and 38% were women. BTC administration began, on average, 689 [483, 1830] days post‐HT. The primary indications for BTC were elevated pre‐formed donor‐specific antibodies in highly sensitized patients (66.6%) and renal sparing (23.8%), in conjunction with reduced calcineurin inhibitor dosage. Only one (4.8%) patient encountered rejection within a year of starting BTC. Graft function by echocardiography remained stable at 6 and 12 months posttreatment. An improvement was observed in serum creatinine levels (76.2% of patients), decreasing from a median of 1.58 to 1.45 (IQR [1.0–2.1] to [1.1–1.9]) over 12 months ( p = .054). eGFR improved at 3 and 6 months compared with 3 months pre‐ BTC levels; however, this was not statistically significant ( p = .24). Treatment discontinuation occurred in seven patients (33.3%) of whom four (19%) were switched back to full dose CNI. Infections occurred in 11 patients (52.4%), ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1111/ctr.15251 |
| الاتاحة: | http://dx.doi.org/10.1111/ctr.15251 https://onlinelibrary.wiley.com/doi/pdf/10.1111/ctr.15251 |
| Rights: | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| رقم الانضمام: | edsbas.3887B3F6 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1111/ctr.15251 |
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