De novo belatacept in clinical vascularized composite allotransplantation.
Am J Transplant
; 18(7): 1804-1809, 2018 07.
Article
in En
| MEDLINE
| ID: mdl-29723921
ABSTRACT
Most immunosuppressive regimens used in clinical vascularized composite allotransplantation (VCA) have been calcineurin inhibitor (CNI)-based. As such, most recipients have experienced CNI-related side effects. Costimulation blockade, specifically CD28/B7 inhibition with belatacept, has emerged as a clinical replacement for CNI-based immunosuppression in kidney transplantation. We have previously shown that belatacept can be used as a centerpiece immunosuppressant for VCA in nonhuman primates, and subsequently reported successful conversion from a CNI-based regimen to a belatacept-based regimen after clinical hand transplantation. We now report on the case of a hand transplant recipient, whom we have successfully treated with a de novo belatacept-based regimen, transitioned to a CNI-free regimen. This case demonstrates that belatacept can provide sufficient prophylaxis from rejection without chronic CNI-associated side effects, a particularly important goal in nonlifesaving solid organ transplants such as VCA.
Key words
Full text:
1
Database:
MEDLINE
Main subject:
Vascularized Composite Allotransplantation
/
Hand Transplantation
/
Abatacept
/
Graft Rejection
/
Graft Survival
/
Immunosuppressive Agents
Type of study:
Etiology_studies
Limits:
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Am J Transplant
Journal subject:
TRANSPLANTE
Year:
2018
Type:
Article
Affiliation country:
United States