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10.1111/ajt.14738

http://scihub22266oqcxt.onion/10.1111/ajt.14738
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suck abstract from ncbi


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pmid29573335
      Am+J+Transplant 2018 ; 18 (7 ): 1774-1782
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  • Posttransplant reduction in preexisting donor-specific antibody levels after belatacept- versus cyclosporine-based immunosuppression: Post hoc analyses of BENEFIT and BENEFIT-EXT #MMPMID29573335
  • Bray RA ; Gebel HM ; Townsend R ; Roberts ME ; Polinsky M ; Yang L ; Meier-Kriesche HU ; Larsen CP
  • Am J Transplant 2018[Jul]; 18 (7 ): 1774-1782 PMID29573335 show ga
  • BENEFIT and BENEFIT-EXT were phase III studies of cytotoxic T-cell crossmatch-negative kidney transplant recipients randomized to belatacept more intense (MI)-based, belatacept less intense (LI)-based, or cyclosporine-based immunosuppression. Following study completion, presence/absence of HLA-specific antibodies was determined centrally via solid-phase flow cytometry screening. Stored sera from anti-HLA-positive patients were further tested with a single-antigen bead assay to determine antibody specificities, presence/absence of donor-specific antibodies (DSAs), and mean fluorescent intensity (MFI) of any DSAs present. The effect of belatacept-based and cyclosporine-based immunosuppression on MFI was explored post hoc in patients with preexisting DSAs enrolled to BENEFIT and BENEFIT-EXT. In BENEFIT, preexisting DSAs were detected in 4.6%, 4.9%, and 6.3% of belatacept MI-treated, belatacept LI-treated, and cyclosporine-treated patients, respectively. The corresponding values in BENEFIT-EXT were 6.0%, 5.7%, and 9.2%. In both studies, most preexisting DSAs were of class I specificity. Over the first 24 months posttransplant, a greater proportion of preexisting DSAs in belatacept-treated versus cyclosporine-treated patients exhibited decreases or no change in MFI. MFI decline was more apparent with belatacept MI-based versus belatacept LI-based immunosuppression in both studies and more pronounced in BENEFIT-EXT versus BENEFIT. Although derived post hoc, these data suggest that belatacept-based immunosuppression decreases preexisting DSAs more effectively than cyclosporine-based immunosuppression.
  • |*Tissue Donors [MESH]
  • |Abatacept/*therapeutic use [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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