For a study, researchers sought to share a personal account of employing a technique for lymphocyte depletion that relies on de novo belatacept (DNB)-based maintenance immunosuppression.
The DNB protocol was defined as belatacept initiated within 7 days of a kidney transplant with steroids and mycophenolate with anti-thymocyte globulin (ATG) induction without concurrent calcineurin inhibitors (CNIs), was used in a retrospective, observational study on 37 kidney transplant recipients.
Patients who underwent kidney transplantation from a deceased donor during the study period and met one or more of the following criteria were included: anticipated cold ischemia time (CIT) greater than 24 h, donation following cardiac death, donor acute kidney injury, and a Kidney Donor Profile Index (KDPI) >85%. At one year, 97.3% of patients and 94.6% of grafts survived. In 40.54% of the patients, there was delayed graft function (DGF). Acute cellular Banff 1B rejection occurred in two individuals. 32.4% of patients had BK viremia found. At 1 year, the study group’s average estimated glomerular filtration rate (eGFR), as determined by the modification of diet in renal disease (MDRD) equation, was 54.7 ml/min/1.73 m2.
They thought that using the DNB procedure, which enabled early CNI avoidance, may reduce the rate of organ discarding.
Reference: onlinelibrary.wiley.com/doi/10.1111/nep.14106
