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10.1111/ajt.14721

http://scihub22266oqcxt.onion/10.1111/ajt.14721
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suck abstract from ncbi


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pmid29509295
      Am+J+Transplant 2018 ; 18 (7 ): 1783-1789
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  • De novo donor-specific antibodies in belatacept-treated vs cyclosporine-treated kidney-transplant recipients: Post hoc analyses of the randomized phase III BENEFIT and BENEFIT-EXT studies #MMPMID29509295
  • Bray RA ; Gebel HM ; Townsend R ; Roberts ME ; Polinsky M ; Yang L ; Meier-Kriesche HU ; Larsen CP
  • Am J Transplant 2018[Jul]; 18 (7 ): 1783-1789 PMID29509295 show ga
  • Donor-specific antibodies (DSAs) are associated with an increased risk of antibody-mediated rejection and graft failure. In BENEFIT and BENEFIT-EXT, kidney-transplant recipients were randomized to receive belatacept more intense (MI)-based, belatacept less intense (LI)-based, or cyclosporine-based immunosuppression for up to 7 years (84 months). The presence/absence of HLA-specific antibodies was determined at baseline, at months 6, 12, 24, 36, 48, 60, and 84, and at the time of clinically suspected episodes of acute rejection, using solid-phase flow-cytometry screening. Samples from anti-HLA-positive patients were further tested with a single-antigen bead assay to determine antibody specificities, presence/absence of DSAs, and mean fluorescence intensity (MFI) of any DSAs present. In BENEFIT, de novo DSAs developed in 1.4%, 3.5%, and 12.1% of belatacept MI-treated, belatacept LI-treated, and cyclosporine-treated patients, respectively. The corresponding values in BENEFIT-EXT were 3.8%, 1.1%, and 11.2%. Per Kaplan-Meier analysis, de novo DSA incidence was significantly lower in belatacept-treated vs cyclosporine-treated patients over 7 years in both studies (P < .01). In patients who developed de novo DSAs, belatacept-based immunosuppression was associated with numerically lower MFI vs cyclosporine-based immunosuppression. Although derived post hoc, these data suggest that belatacept-based immunosuppression suppresses de novo DSA development more effectively than cyclosporine-based immunosuppression.
  • |*Tissue Donors [MESH]
  • |Abatacept/*therapeutic use [MESH]
  • |Adult [MESH]
  • |Cyclosporine/*therapeutic use [MESH]
  • |Female [MESH]
  • |Follow-Up Studies [MESH]
  • |Graft Rejection/blood/*drug therapy/etiology [MESH]
  • |Graft Survival/immunology [MESH]
  • |Humans [MESH]
  • |Immune Tolerance/immunology [MESH]
  • |Immunosuppressive Agents/therapeutic use [MESH]
  • |International Agencies [MESH]
  • |Isoantibodies/*blood/immunology [MESH]
  • |Kidney Failure, Chronic/*surgery [MESH]
  • |Kidney Transplantation/*adverse effects [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Postoperative Complications [MESH]
  • |Prognosis [MESH]
  • |Risk Factors [MESH]


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