ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2021
Optimization of de novo belatacept-based immunosuppression administered to renal transplant recipients.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 32 citations in OpenAlex.
- Belatacept in Solid Organ Transplantation: Current Kidney Applications, Future Perspectives in Other Organs, and Clinical Implications.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Renal Replacement Therapy in Cardiovascular-Kidney-Metabolic Syndrome: Challenges for Dialytic Therapies and Kidney Transplantation.Cardiorenal medicine · 2026Review
- Interactions Between Immunosuppressive Regimens and Cytomegalovirus Infection After Solid-Organ Transplantation.Transplant international : official journal of the European Society for Organ Transplantation · 2026Review
- Belatacept-based immunosuppression in heart transplant recipients: A single center experience.JHLT open · 2025Article
- One-Year Outcomes After Belatacept Conversion in Adolescent Kidney Transplant Recipients.Kidney international reports · 2025Article
- New Onset Diabetes After Organ Transplantation: Risk Factors, Treatment, and Consequences.Diagnostics (Basel, Switzerland) · 2025Review
- Immunosuppression Management in Heart Transplantation.Methodist DeBakey cardiovascular journal · 2025Review
- Article
- International consensus on post-transplantation diabetes mellitus.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Article
- Costimulatory Blockade and Solid Organ Transplantation: The Past, Present, and Future.Kidney international reports · 2023Review
- Desensitization and belatacept-based maintenance therapy in pregnancy-sensitized monkeys receiving a kidney transplant.Science advances · 2023Article
- mTOR Inhibition Impairs the Activation and Function of Belatacept-Resistant CD4Pharmaceutics · 2023Article
- Three-year Outcomes After Conversion From Monthly to Every 2-month Belatacept Maintenance Therapy in Kidney Transplant Recipients: Results From a Randomized Controlled Trial.Transplantation direct · 2023Article
- Preservation of Antiviral Immunologic Efficacy Without Alloimmunity After Switch to Belatacept in Calcineurin Inhibitor-Intolerant Patients.Kidney international reports · 2023Article
- Impact of belatacept and tacrolimus on cytomegalovirus viral load control and relapse in moderate and high-risk cytomegalovirus serostatus kidney transplant recipients.Transplant infectious disease : an official journal of the Transplantation Society · 2022Article
- Delayed Graft Function in Kidney Transplant: Risk Factors, Consequences and Prevention Strategies.Journal of personalized medicine · 2022Review
- Detecting, preventing and treating non-adherence to immunosuppression after kidney transplantation.Clinical kidney journal · 2022Review
- Harnessing the B Cell Response in Kidney Transplantation - Current State and Future Directions.Frontiers in immunology · 2022Review
- Belatacept Conversion in Kidney After Liver Transplantation.Transplantation direct · 2021Article
- The new era of treatments for kidney transplant recipients.Jornal brasileiro de nefrologiaReview
Corrections and comments
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Authors and funding
9 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Kidney transplant recipients administered belatacept-based maintenance immunosuppression present with a more favorable metabolic profile, reduced incidence of de novo donor-specific antibodies (DSAs), and improved renal function and long-term patient/graft survival relative to individuals receiving calcineurin inhibitor (CNI)-based immunosuppression. However, the rates and severity of acute rejection (AR) are greater with the approved belatacept-based regimen than with CNI-based immunosuppression. Although these early co-stimulation blockade-resistant rejections are typically steroid sensitive, the higher rate of cellular AR has led many transplant centers to adopt immunosuppressive regimens that differ from the approved label. This article summarizes the available data on these alternative de novo belatacept-based maintenance regimens. Steroid-sparing, belatacept-based immunosuppression (following T cell-depleting induction therapy) has been shown to yield AR rates comparable to those seen with CNI-based regimens. Concomitant treatment with belatacept plus a mammalian target of rapamycin inhibitor (mTORi; sirolimus or everolimus) has yielded AR rates ranging from 0 to 4%. Because the optimal induction agent and number of induction doses; blood levels of mTORi; and dose, duration, and use of corticosteroids have yet to be determined, larger prospective clinical trials are needed to establish the optimal alternative belatacept-based regimen for minimizing early cellular AR occurrence.
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