Maintenance Belatacept-Based Immunosuppression in Lung Transplantation Recipients Who Failed Calcineurin Inhibitors

Iasella, Carlo J.; Winstead, Ryan; Moore, Cody A.; Johnson, Bruce A.; Feinberg, A.; Morrell, Matthew R.; Hayanga, J.W. Awori; Lendermon, Elizabeth A.; Zeevi, Adriana; McDyer, John F.; Ensor, Christopher R.

doi:10.1097/tp.0000000000001873

Cited by 54 publications

(42 citation statements)

References 14 publications

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“…Belatacept is a selective co-stimulation blocker that binds to membrane CD80 and CD86 of APCs; it has been applied in immunosuppression during lung, kidney, and heart transplantation [95] , [96] , [97] . However, renal insufficiency was found in lung transplant recipients receiving belatacept; hence, multicenter prospective studies are required to evaluate the safety and efficacy of this drug [98] , [99] . Abatacept is closely related to belatacept and acts as an immunosuppressant marketed for rheumatic diseases [100] .…”

Section: Discussionmentioning

confidence: 99%

Screening and identification of key regulatory connections and immune cell infiltration characteristics for lung transplant rejection using mucosal biopsies

Xiu

Liu

Tang

2020

International Immunopharmacology

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Highlights Identifying hub genes for lung allograft rejection. Constructing a miRNA-TF-mRNA regulatory network in lung allograft rejection. Revealing dysregulation of immune cells during lung allograft rejection. Revealing potential relationships between hub gene expression and immune cell infiltration level. Predicting potential drugs for the treatment of lung allograft rejection.

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Section: Discussionmentioning

confidence: 99%

Screening and identification of key regulatory connections and immune cell infiltration characteristics for lung transplant rejection using mucosal biopsies

Xiu

Liu

Tang

2020

International Immunopharmacology

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“…3 Contradictory outcomes have been reported with the use of BTC in liver transplantation. 7,8 To our knowledge, this is the first case series describing BTC therapy in heart transplant recipients. 6 Multiple factors might account for differences in patient survival among kidney and liver transplant recipients, which can be partly explained by organ-specific aspects of alloimmune responses.…”

Section: Introductionmentioning

confidence: 91%

“…6 The use of BTC has been described in only two case series (8 and 11 patients, respectively) of lung transplant recipients. 7,8 To our knowledge, this is the first case series describing BTC therapy in heart transplant recipients.…”

mentioning

confidence: 91%

Belatacept-based immunosuppression: A calcineurin inhibitor-sparing regimen in heart transplant recipients

Launay

Guitard

Dorent

et al. 2020

American Journal of Transplantation

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| INTRODUC TI ONCalcineurin inhibitors (CNI) are the backbone of immunosuppression in solid organ transplantation, but long-term exposure is often associated with nephrotoxicity. 1 Belatacept (BTC) (Nulojix ® ) is a highaffinity CTLA4Ig indicated for the prophylaxis of graft rejection in adults receiving a renal transplant in combination with mycophenolic acid (MPA) and corticosteroids. 2,3 The BENEFIT study demonstrated that BTC-based regimens were associated with a similar incidence of acute rejection but improved renal function compared to a cyclosporine-based regimen in renal transplant recipients. 4 The BENEFIT and BENEFIT-EXT studies showed that the risk of posttransplant

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“…Four patients died throughout the end of the follow‐up. The observed consistency of ACR prevention, uniformity of secondary outcomes, and reduction in renal burden are encouraging for belatacept use in lung transplant …”

Section: Belataceptmentioning

confidence: 82%

Belatacept for maintenance immunosuppression in cardiothoracic transplantation: The potential frontier

Ensor

Goehring

Iasella

et al. 2018

Clinical Transplantation

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Current immunosuppressive regimens with calcineurin inhibitors have improved the management of patients after transplantation. However, their adverse effects are linked to increased morbidity and limit the long-term survival of heart and lung transplant recipients. Belatacept, a costimulation inhibitor interfering with the interaction between CD28 on T cells and the B7 ligands on antigen presenting cells, has shown success and is currently approved for use in renal transplant recipients. Furthermore, it lacks many of the cardiovascular, metabolic, neurologic, and renal adverse of effects of calcineurin inhibitors that have the largest impact on long-term survival in cardiothoracic transplant. Additionally, it requires no therapeutic drug monitoring and is only administered once a month. Limitations to belatacept use have been observed that must be considered when comparing immunosuppression options. Despite this, maintenance immunosuppression with belatacept has the potential to improve outcomes in cardiothoracic transplant recipients, as it has with kidney transplant recipients. However, no large clinical trials investigating belatacept for maintenance immunosuppression in heart and lung transplant recipients exist. There is a large need for focused research of belatacept in cardiothoracic transplantation. Belatacept is a viable treatment option for maintenance immunosuppression, and it is reasonable to pursue more evidence in cardiothoracic transplant recipients.

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Maintenance Belatacept-Based Immunosuppression in Lung Transplantation Recipients Who Failed Calcineurin Inhibitors

Abstract: Belatacept-based ISR appear to produce reasonable results in LTRs who fail CNI-based ISR. Larger prospective trials appear warranted in lung transplantation.

Cited by 54 publications

References 14 publications

Screening and identification of key regulatory connections and immune cell infiltration characteristics for lung transplant rejection using mucosal biopsies

Screening and identification of key regulatory connections and immune cell infiltration characteristics for lung transplant rejection using mucosal biopsies

Belatacept-based immunosuppression: A calcineurin inhibitor-sparing regimen in heart transplant recipients

Belatacept for maintenance immunosuppression in cardiothoracic transplantation: The potential frontier

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