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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Am+J+Transplant
2018 ; 18
(7
): 1774-1782
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gab.com Text
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English Wikipedia
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.