Early conversion to belatacept after renal transplantation

Belatacept is a non-nephrotoxic immunosuppressive agent, which may make it the ideal agent for patients with delayed or slow graft function on calcineurin inhibitors. There are limited data on conversion of patients to belatacept within 6 months of transplantation. Between 1/2012 and 12/2015 sixteen patients were converted to belatacept for delayed or poor graft function (eGFR <30 ml/min/1.73m, MDRD); three were HIV+. Conversion protocols were analyzed in patients < 4 months and 4-6 months post transplantation. Mean serum creatinine levels after belatacept conversion were compared with pre-conversion levels. Patient survival was 100%, and graft survival was 88%. The mean creatinine fell from 3.9 ± 1.82 mg/dl pre belatacept conversion to 2.1 ±1.1 mg/dl at 6 months and 1.9 ± 0.47 mg/dl (median 1.8 mg/dl) at 12 months post conversion. There was no significant increased risk of rejection, infection or malignancy. HIV parameters remained largely stable. Early conversion to belatacept in patients with DGF or slow graft function is safe and efficacious, in a single center non randomized retrospective analysis. This article is protected by copyright. All rights reserved.