ReviewClinical transplantation2026
Belatacept Conversion in Simultaneous Pancreas-Kidney and Liver-Kidney Transplant Recipients: A Single-Center Feasibility Cohort and Narrative Review.
Review in Clinical transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCalcineurin inhibitor (CNI) nephrotoxicity drives long-term kidney-function decline after simultaneous pancreas-kidney (SPK) and liver-kidney (LK) transplantation, but belatacept conversion, as an alternative strategy, is poorly studied in these recipients, whose non-kidney allograft rejection risk differs.
methodsWe retrospectively studied six SPK and six LK recipients converted from CNI- to belatacept-based immunosuppression and analyzed the cohorts separately alongside a narrative review of published SPK/LK conversion experiences. Outcomes were estimated glomerular filtration rate (eGFR) trajectories and slopes, donor-specific antibodies (DSA) and rejection, pancreatic, hepatic and metabolic parameters, infections, and survival, reported descriptively with exploratory estimates and 95% confidence intervals (CI).
resultsConversion occurred a median of 64 (SPK) and 89 (LK) months after transplantation, always with a transient low-dose CNI overlap (target trough 3-4 ng/ml). In SPK recipients, median eGFR rose from 45.4 to 55.5 mL/min/1.73m
conclusionsLate belatacept conversion with a transient low-dose CNI overlap was feasible in selected SPK and LK recipients and was associated with stable-to-improved kidney function without a pancreatic or hepatic safety signal. The uncontrolled design supports feasibility, not efficacy.
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