De novo belatacept in clinical vascularized composite allotransplantation.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Cendales, LC; Ruch, DS; Cardones, AR; Potter, G; Dooley, J; Dore, D; Orr, J; Ruskin, G; Song, M; Chen, D-F; Selim, MA; Kirk, AD

Published Date

  • July 2018

Published In

Volume / Issue

  • 18 / 7

Start / End Page

  • 1804 - 1809

PubMed ID

  • 29723921

Electronic International Standard Serial Number (EISSN)

  • 1600-6143

Digital Object Identifier (DOI)

  • 10.1111/ajt.14910


  • eng

Conference Location

  • United States