The impact of belatacept on third‐party HLA alloantibodies in highly sensitized kidney transplant recipients. Issue 2 (8th October 2019)

• Record Type: Journal Article
• Authors: Parsons, Ronald F.; Zahid, Arslan; Bumb, Shalini; Decker, Hannah; Sullivan, Harold C.; Eun‐Hyung Lee, Frances; Badell, Idelberto Raul; Ford, Mandy L.; Larsen, Christian P.; Pearson, Thomas C.; Jackson, Annette M.; Chen, Dong‐Feng; Levine, Matthew; Kamoun, Malek; Bray, Robert A.; Gebel, Howard M.
• Is Part Of: American journal of transplantation. Volume 20:Issue 2(2020)
• Page Start: 573
• Page End: 581
• Publication Date: 2019-10-08
• Subjects: alloantibody -- clinical research/practice -- immunosuppressant ‐ fusion proteins and monoclonal antibodies: belatacept -- immunosuppression/immune modulation -- kidney transplantation/nephrology -- sensitization; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.15585
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : Recent evidence suggests that belatacept reduces the durability of preexisting antibodies to class I and class II human leukocyte antigens (HLAs). In this case series of 163 highly sensitized kidney transplant candidates whose calculated panel‐reactive antibody (cPRA) activity was ≥98% to 100%, the impact of belatacept on preexisting HLA antibodies was assessed. Of the 163 candidates, 72 underwent transplantation between December 4, 2014 and April 15, 2017; 60 of these transplanted patients remained on belatacept consecutively for at least 6 months. We observed a decrease in the breadth and/or strength of HLA class I antibodies as assessed by FlowPRA in belatacept‐treated patients compared to controls who did not receive belatacept. Specifically, significant HLA antibody reduction was evident for class I ( P < .0009). Posttransplant belatacept‐treated patients also had a clinically significant reduction in their cPRA compared to controls ( P < .01). Collectively, these findings suggest belatacept can reduce HLA class I antibodies in a significant proportion of highly sensitized recipients and could be an option to improve pretransplant compatibility with organ donors. Abstract : This study suggests that belatacept reduces third‐party HLA class I antibodies in a significant proportion of highly sensitized kidney transplant recipients and may be another pretransplant option for patient desensitization.