De novo belatacept in clinical vascularized composite allotransplantation

Linda C. Cendales*, David S. Ruch, Adela R. Cardones, Guy Potter, Joshua Dooley, Daniel Dore, Jonah Orr, Gregory Ruskin, Mingqing Song, Dong Feng Chen, Maria A. Selim, Allan D. Kirk

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Most immunosuppressive regimens used in clinical vascularized composite allotransplantation (VCA) have been calcineurin inhibitor (CNI)-based. As such, most recipients have experienced CNI-related side effects. Costimulation blockade, specifically CD28/B7 inhibition with belatacept, has emerged as a clinical replacement for CNI-based immunosuppression in kidney transplantation. We have previously shown that belatacept can be used as a centerpiece immunosuppressant for VCA in nonhuman primates, and subsequently reported successful conversion from a CNI-based regimen to a belatacept-based regimen after clinical hand transplantation. We now report on the case of a hand transplant recipient, whom we have successfully treated with a de novo belatacept-based regimen, transitioned to a CNI–free regimen. This case demonstrates that belatacept can provide sufficient prophylaxis from rejection without chronic CNI-associated side effects, a particularly important goal in nonlifesaving solid organ transplants such as VCA.

Original languageEnglish
Pages (from-to)1804-1809
Number of pages6
JournalAmerican Journal of Transplantation
Volume18
Issue number7
DOIs
StatePublished - Jul 2018
Externally publishedYes

Keywords

  • clinical research/practice
  • clinical trial
  • costimulation
  • immunosuppressant - fusion proteins and monoclonal antibodies: belatacept
  • immunosuppression/immune modulation
  • vascularized composite and reconstructive transplantation

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