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De Novo Belatacept in a Kidney-After-Heart Transplant Recipient

Renal injury almost always accompanies the multisystem organ failure that precedes cardiac transplantation and renal function is further compromised by the nephrotoxicity of calcineurin inhibitors posttransplant. Renal dysfunction in turn causes significant morbidity and mortality. The development o...

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Autores principales: Schenk, Austin D., Anderson, Douglas J., Cole, Robert T., Badell, Idelberto R., Larsen, Christopher P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6964935/
https://www.ncbi.nlm.nih.gov/pubmed/32047843
http://dx.doi.org/10.1097/TXD.0000000000000967
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author Schenk, Austin D.
Anderson, Douglas J.
Cole, Robert T.
Badell, Idelberto R.
Larsen, Christopher P.
author_facet Schenk, Austin D.
Anderson, Douglas J.
Cole, Robert T.
Badell, Idelberto R.
Larsen, Christopher P.
author_sort Schenk, Austin D.
collection PubMed
description Renal injury almost always accompanies the multisystem organ failure that precedes cardiac transplantation and renal function is further compromised by the nephrotoxicity of calcineurin inhibitors posttransplant. Renal dysfunction in turn causes significant morbidity and mortality. The development of belatacept was motivated by need for an alternative to calcineurin-based immunosuppression, particularly in renal transplantation where the nephrotoxicity of calcineurin inhibitors reduce graft longevity and adverse cardiovascular effects of calcineurin inhibitors increase overall mortality. In 2011, the FDA approved belatacept for use in renal transplantation. Seven-year data from the multicenter randomized phase III BENEFIT trial, which compared belatacept with cyclosporine in renal transplant recipients, show belatacept therapy offers both improved renal function and 43% risk reduction for the combined endpoint of graft loss and death. At present, belatacept use is predominantly confined to renal transplant recipients; however, reports of belatacept use in other transplant settings are emerging. Here, we describe successful long-term use of belatacept in a kidney-after-heart transplant recipient and review use of belatacept in cardiothoracic and other nonrenal transplant settings.
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spelling pubmed-69649352020-02-11 De Novo Belatacept in a Kidney-After-Heart Transplant Recipient Schenk, Austin D. Anderson, Douglas J. Cole, Robert T. Badell, Idelberto R. Larsen, Christopher P. Transplant Direct Heart Transplantation Renal injury almost always accompanies the multisystem organ failure that precedes cardiac transplantation and renal function is further compromised by the nephrotoxicity of calcineurin inhibitors posttransplant. Renal dysfunction in turn causes significant morbidity and mortality. The development of belatacept was motivated by need for an alternative to calcineurin-based immunosuppression, particularly in renal transplantation where the nephrotoxicity of calcineurin inhibitors reduce graft longevity and adverse cardiovascular effects of calcineurin inhibitors increase overall mortality. In 2011, the FDA approved belatacept for use in renal transplantation. Seven-year data from the multicenter randomized phase III BENEFIT trial, which compared belatacept with cyclosporine in renal transplant recipients, show belatacept therapy offers both improved renal function and 43% risk reduction for the combined endpoint of graft loss and death. At present, belatacept use is predominantly confined to renal transplant recipients; however, reports of belatacept use in other transplant settings are emerging. Here, we describe successful long-term use of belatacept in a kidney-after-heart transplant recipient and review use of belatacept in cardiothoracic and other nonrenal transplant settings. Wolters Kluwer Health 2019-12-24 /pmc/articles/PMC6964935/ /pubmed/32047843 http://dx.doi.org/10.1097/TXD.0000000000000967 Text en Copyright © 2019 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Heart Transplantation
Schenk, Austin D.
Anderson, Douglas J.
Cole, Robert T.
Badell, Idelberto R.
Larsen, Christopher P.
De Novo Belatacept in a Kidney-After-Heart Transplant Recipient
title De Novo Belatacept in a Kidney-After-Heart Transplant Recipient
title_full De Novo Belatacept in a Kidney-After-Heart Transplant Recipient
title_fullStr De Novo Belatacept in a Kidney-After-Heart Transplant Recipient
title_full_unstemmed De Novo Belatacept in a Kidney-After-Heart Transplant Recipient
title_short De Novo Belatacept in a Kidney-After-Heart Transplant Recipient
title_sort de novo belatacept in a kidney-after-heart transplant recipient
topic Heart Transplantation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6964935/
https://www.ncbi.nlm.nih.gov/pubmed/32047843
http://dx.doi.org/10.1097/TXD.0000000000000967
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