AI Article Synopsis
- The standard immunosuppressive regimen after organ transplantation typically includes drugs like tacrolimus, mycophenolic acid, and corticosteroids, which can cause side effects like kidney damage.
- Belatacept offers a promising alternative by blocking a key costimulation pathway, showing improved kidney function and reduced donor-specific antibodies in early studies, despite a higher risk of acute rejections.
- Research highlights the benefits of converting to belatacept within the first six months after kidney transplantation, while also emphasizing the need for careful monitoring of rejection and infection risks.
Article Abstract
The standard immunosuppressive treatment after organ transplantation typically includes a calcineurin inhibitor (tacrolimus or cyclosporine A), an antimetabolite (mycophenolic acid) or an mTOR inhibitor, and corticosteroids. However, these treatments are associated with multiple side effects, including nephrotoxicity. Belatacept, a fusion protein blocking the CD80/86 costimulation pathway, emerges as an effective and well-tolerated alternative. Initial phase III studies showed that de novo belatacept improves renal function and reduces the incidence of donor-specific antibodies, despite a higher rate of acute cellular rejections. Early conversion studies (within the first 6 months post-transplantation) demonstrate significant improvement in renal function, particularly when conversion is performed early. However, the risk of acute rejection and opportunistic infections must be monitored. This article summarizes the available studies on early conversion to belatacept in kidney transplanted patients.
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