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The impact of belatacept on third‐party HLA alloantibodies in highly sensitized kidney transplant recipients
Author(s) -
Parsons Ronald F.,
Zahid Arslan,
Bumb Shalini,
Decker Hannah,
Sullivan Harold C.,
EunHyung Lee Frances,
Badell Idelberto Raul,
Ford Mandy L.,
Larsen Christian P.,
Pearson Thomas C.,
Jackson Annette M.,
Chen DongFeng,
Levine Matthew,
Kamoun Malek,
Bray Robert A.,
Gebel Howard M.
Publication year - 2020
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.15585
Subject(s) - belatacept , medicine , human leukocyte antigen , kidney transplantation , transplantation , abatacept , immunology , panel reactive antibody , immunosuppression , antibody , antigen , kidney transplant , rituximab
Recent evidence suggests that belatacept reduces the durability of preexisting antibodies to class I and class II human leukocyte antigens ( HLA s). In this case series of 163 highly sensitized kidney transplant candidates whose calculated panel‐reactive antibody ( cPRA ) activity was ≥98% to 100%, the impact of belatacept on preexisting HLA antibodies was assessed. Of the 163 candidates, 72 underwent transplantation between December 4, 2014 and April 15, 2017; 60 of these transplanted patients remained on belatacept consecutively for at least 6 months. We observed a decrease in the breadth and/or strength of HLA class I antibodies as assessed by Flow PRA in belatacept‐treated patients compared to controls who did not receive belatacept. Specifically, significant HLA antibody reduction was evident for class I ( P < .0009). Posttransplant belatacept‐treated patients also had a clinically significant reduction in their cPRA compared to controls ( P < .01). Collectively, these findings suggest belatacept can reduce HLA class I antibodies in a significant proportion of highly sensitized recipients and could be an option to improve pretransplant compatibility with organ donors.