Conversion from tacrolimus to belatacept improves renal function in kidney transplant patients with chronic vascular lesions in allograft biopsy.
creatinine clearance
immunosuppression
kidney transplantation
renal biopsy
tacrolimus
Journal
Clinical kidney journal
ISSN: 2048-8505
Titre abrégé: Clin Kidney J
Pays: England
ID NLM: 101579321
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
21
08
2018
entrez:
7
8
2019
pubmed:
7
8
2019
medline:
7
8
2019
Statut:
epublish
Résumé
Conversion from tacrolimus to belatacept has been shown to be beneficial for an increasing number of kidney transplant (KT) patients. Predicting factors for favorable outcomes are still unknown. We aimed to investigate whether histological vascular lesions at the time of conversion might correlate with greater improvement in renal function post-conversion. The study was conducted on a retrospective cohort of 34 KT patients converted from tacrolimus to belatacept. All patients underwent an allograft biopsy prior to conversion. We analyzed the evolution of the estimated glomerular filtration rate (eGFR) at 3 and 12 months after conversion. Median time to conversion was 6 (2-37.2) months post-transplant. About 52.9% of patients had moderate-to-severe chronic vascular lesions (cv2-3). We observed an increase in eGFR in the whole cohort from 35.4 to 41 mL/min/1.73 m Conversion from tacrolimus to belatacept has a beneficial effect in terms of renal function in KT patients. This benefit might be more significant in patients with cv in the biopsy.
Sections du résumé
BACKGROUND
BACKGROUND
Conversion from tacrolimus to belatacept has been shown to be beneficial for an increasing number of kidney transplant (KT) patients. Predicting factors for favorable outcomes are still unknown. We aimed to investigate whether histological vascular lesions at the time of conversion might correlate with greater improvement in renal function post-conversion.
METHODS
METHODS
The study was conducted on a retrospective cohort of 34 KT patients converted from tacrolimus to belatacept. All patients underwent an allograft biopsy prior to conversion. We analyzed the evolution of the estimated glomerular filtration rate (eGFR) at 3 and 12 months after conversion.
RESULTS
RESULTS
Median time to conversion was 6 (2-37.2) months post-transplant. About 52.9% of patients had moderate-to-severe chronic vascular lesions (cv2-3). We observed an increase in eGFR in the whole cohort from 35.4 to 41 mL/min/1.73 m
CONCLUSIONS
CONCLUSIONS
Conversion from tacrolimus to belatacept has a beneficial effect in terms of renal function in KT patients. This benefit might be more significant in patients with cv in the biopsy.
Identifiants
pubmed: 31384452
doi: 10.1093/ckj/sfy115
pii: sfy115
pmc: PMC6671390
doi:
Types de publication
Journal Article
Langues
eng
Pagination
586-591Subventions
Organisme : NIDDK NIH HHS
ID : R37 DK039773
Pays : United States
Organisme : NIDDK NIH HHS
ID : T32 DK007527
Pays : United States
Références
N Engl J Med. 2003 Dec 11;349(24):2326-33
pubmed: 14668458
Transplantation. 2004 Aug 27;78(4):557-65
pubmed: 15446315
Clin Transplant. 2007 May-Jun;21(3):330-6
pubmed: 17488381
Clin J Am Soc Nephrol. 2009 Feb;4(2):481-508
pubmed: 19218475
J Am Soc Nephrol. 2009 Jun;20(6):1404-15
pubmed: 19470683
Am J Transplant. 2010 Mar;10(3):535-46
pubmed: 20415897
Am J Transplant. 2010 Mar;10(3):547-57
pubmed: 20415898
Clin J Am Soc Nephrol. 2011 Feb;6(2):430-9
pubmed: 21051752
Transplantation. 2011 May 15;91(9):976-83
pubmed: 21372756
Am J Transplant. 2011 Apr;11(4):693-7
pubmed: 21446974
Pharmacol Res. 2011 Jul;64(1):25-30
pubmed: 21473913
Transplantation. 2012 Mar 27;93(6):624-31
pubmed: 22334041
Am J Transplant. 2014 Feb;14(2):272-83
pubmed: 24472190
Am J Transplant. 2016 Jul;16(7):2181-6
pubmed: 26718625
Transpl Int. 2016 Nov;29(11):1184-1195
pubmed: 27514317
Am J Kidney Dis. 2017 May;69(5):587-594
pubmed: 27889299
Clin Transplant. 2017 May;31(5):
pubmed: 28190259
Clin Transplant. 2017 May;31(5):
pubmed: 28267882
Am J Transplant. 2017 Nov;17(11):2937-2944
pubmed: 28707779
Transplant Proc. 2017 Oct;49(8):1747-1756.e1
pubmed: 28923620
Transplantation. 2018 Mar;102(3):478-483
pubmed: 29077658
Transplantation. 2018 Sep;102(9):1545-1552
pubmed: 29570163
Ann N Y Acad Sci. 1994 Jun 30;717:209-12
pubmed: 8030836