Long-term outcome of belatacept therapy in de novo kidney transplant recipients - a case-match analysis

Transpl Int. 2015 Jul;28(7):820-7. doi: 10.1111/tri.12544. Epub 2015 Mar 6.

Abstract

While belatacept has shown favorable short- and midterm results in kidney transplant recipients, only projections exist regarding its potential impact on long-term outcome. Therefore, we performed a retrospective case-match analysis of the 14 belatacept patients originally enrolled in the phase II multicenter trial at our center. Fifty six cyclosporine (CyA)-treated patients were matched according to age at transplantation, first/retransplant, and donor type. Ten years after kidney transplantation, kidney function remained superior in belatacept-treated patients compared with the CyA control group. Moreover, none of the belatacept-treated patients had donor-specific antibodies ≥10 years post-transplantation compared with 38.5% of tested CyA-treated subject (0/10 vs. 5/13; P = 0.045). Notably, however, patient and graft survival was virtually identical in both groups (71.4% vs. 71.3%; P = 0.976). In the present single-center study population, patients treated with belatacept demonstrated a patient and graft survival at 10 years post-transplant which was comparable to that of similarly selected CNI-treated patients. Larger studies with sufficient statistical power are necessary to definitively determine long-term graft survival with belatacept.

Keywords: belatacept; immunosuppression; kidney transplantation; long-term outcome.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Abatacept / therapeutic use*
  • Adult
  • Aged
  • Cyclosporine / therapeutic use
  • Female
  • Graft Rejection / diagnosis
  • Graft Rejection / immunology
  • Graft Rejection / mortality
  • Graft Rejection / prevention & control*
  • Graft Survival / immunology
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / surgery*
  • Kidney Function Tests
  • Kidney Transplantation* / mortality
  • Male
  • Matched-Pair Analysis
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Abatacept
  • Cyclosporine