Conversion from tacrolimus to belatacept improves renal function in kidney transplant patients with chronic vascular lesions in allograft biops

BACKGROUND: Conversion from tacrolimus to belatacept has been shown to be beneficial for an increasing number of kidney transplant (KT) patients. Predicting factors for favorable outcomes are still unknown. We aimed to investigate whether histological vascular lesions at the time of conversion might...

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Autores: Pérez-Sáez, María José, Yu, Bryant, Uffing, Audrey, Murakami, Naoka, Borges, Thiago J., Azzi, Jamil, El Haji, Sandra, Gabardi, Steve, Riella, Leonardo V.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/42999
Acceso en línea:http://hdl.handle.net/10230/42999
http://dx.doi.org/10.1093/ckj/sfy115
Access Level:acceso abierto
Palabra clave:Creatinine clearance
Immunosuppression
Kidney transplantation
Renal biopsy
Tacrolimus
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spelling Conversion from tacrolimus to belatacept improves renal function in kidney transplant patients with chronic vascular lesions in allograft biopsPérez-Sáez, María JoséYu, BryantUffing, AudreyMurakami, NaokaBorges, Thiago J.Azzi, JamilEl Haji, SandraGabardi, SteveRiella, Leonardo V.Creatinine clearanceImmunosuppressionKidney transplantationRenal biopsyTacrolimusBACKGROUND: Conversion from tacrolimus to belatacept has been shown to be beneficial for an increasing number of kidney transplant (KT) patients. Predicting factors for favorable outcomes are still unknown. We aimed to investigate whether histological vascular lesions at the time of conversion might correlate with greater improvement in renal function post-conversion. METHODS: The study was conducted on a retrospective cohort of 34 KT patients converted from tacrolimus to belatacept. All patients underwent an allograft biopsy prior to conversion. We analyzed the evolution of the estimated glomerular filtration rate (eGFR) at 3 and 12 months after conversion. RESULTS: Median time to conversion was 6 (2-37.2) months post-transplant. About 52.9% of patients had moderate-to-severe chronic vascular lesions (cv2-3). We observed an increase in eGFR in the whole cohort from 35.4 to 41 mL/min/1.73 m2 at 3 months (P = 0.032) and 43.7 at 12 months (P = 0.013). Nine patients experienced acute rejection post-conversion, with one graft loss observed beyond the first year after conversion. Patients with cv2-3 had significant improvement in eGFR at 12 months (+8.6 mL/min/1.73 m2; 31.6 to 40.2 mL/min/1.73 m2; P = 0.047) compared with those without these lesions (+6.8 mL/min/1.73 m2; 40.9 to 47.7 mL/min/1.73 m2; P = 0.148). CONCLUSIONS: Conversion from tacrolimus to belatacept has a beneficial effect in terms of renal function in KT patients. This benefit might be more significant in patients with cv in the biopsy.Oxford University Press201920192018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/42999http://dx.doi.org/10.1093/ckj/sfy115reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésClinical Kidney Journal. 2018 Dec 1;12(4):586-91Copyright © The Author(s) 2018. Published by Oxford University Press on behalf of ERA-EDTA. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.comhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/429992026-06-12T07:21:37Z
dc.title.none.fl_str_mv Conversion from tacrolimus to belatacept improves renal function in kidney transplant patients with chronic vascular lesions in allograft biops
title Conversion from tacrolimus to belatacept improves renal function in kidney transplant patients with chronic vascular lesions in allograft biops
spellingShingle Conversion from tacrolimus to belatacept improves renal function in kidney transplant patients with chronic vascular lesions in allograft biops
Pérez-Sáez, María José
Creatinine clearance
Immunosuppression
Kidney transplantation
Renal biopsy
Tacrolimus
title_short Conversion from tacrolimus to belatacept improves renal function in kidney transplant patients with chronic vascular lesions in allograft biops
title_full Conversion from tacrolimus to belatacept improves renal function in kidney transplant patients with chronic vascular lesions in allograft biops
title_fullStr Conversion from tacrolimus to belatacept improves renal function in kidney transplant patients with chronic vascular lesions in allograft biops
title_full_unstemmed Conversion from tacrolimus to belatacept improves renal function in kidney transplant patients with chronic vascular lesions in allograft biops
title_sort Conversion from tacrolimus to belatacept improves renal function in kidney transplant patients with chronic vascular lesions in allograft biops
dc.creator.none.fl_str_mv Pérez-Sáez, María José
Yu, Bryant
Uffing, Audrey
Murakami, Naoka
Borges, Thiago J.
Azzi, Jamil
El Haji, Sandra
Gabardi, Steve
Riella, Leonardo V.
author Pérez-Sáez, María José
author_facet Pérez-Sáez, María José
Yu, Bryant
Uffing, Audrey
Murakami, Naoka
Borges, Thiago J.
Azzi, Jamil
El Haji, Sandra
Gabardi, Steve
Riella, Leonardo V.
author_role author
author2 Yu, Bryant
Uffing, Audrey
Murakami, Naoka
Borges, Thiago J.
Azzi, Jamil
El Haji, Sandra
Gabardi, Steve
Riella, Leonardo V.
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Creatinine clearance
Immunosuppression
Kidney transplantation
Renal biopsy
Tacrolimus
topic Creatinine clearance
Immunosuppression
Kidney transplantation
Renal biopsy
Tacrolimus
description BACKGROUND: Conversion from tacrolimus to belatacept has been shown to be beneficial for an increasing number of kidney transplant (KT) patients. Predicting factors for favorable outcomes are still unknown. We aimed to investigate whether histological vascular lesions at the time of conversion might correlate with greater improvement in renal function post-conversion. METHODS: The study was conducted on a retrospective cohort of 34 KT patients converted from tacrolimus to belatacept. All patients underwent an allograft biopsy prior to conversion. We analyzed the evolution of the estimated glomerular filtration rate (eGFR) at 3 and 12 months after conversion. RESULTS: Median time to conversion was 6 (2-37.2) months post-transplant. About 52.9% of patients had moderate-to-severe chronic vascular lesions (cv2-3). We observed an increase in eGFR in the whole cohort from 35.4 to 41 mL/min/1.73 m2 at 3 months (P = 0.032) and 43.7 at 12 months (P = 0.013). Nine patients experienced acute rejection post-conversion, with one graft loss observed beyond the first year after conversion. Patients with cv2-3 had significant improvement in eGFR at 12 months (+8.6 mL/min/1.73 m2; 31.6 to 40.2 mL/min/1.73 m2; P = 0.047) compared with those without these lesions (+6.8 mL/min/1.73 m2; 40.9 to 47.7 mL/min/1.73 m2; P = 0.148). CONCLUSIONS: Conversion from tacrolimus to belatacept has a beneficial effect in terms of renal function in KT patients. This benefit might be more significant in patients with cv in the biopsy.
publishDate 2018
dc.date.none.fl_str_mv 2018
2019
2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/42999
http://dx.doi.org/10.1093/ckj/sfy115
url http://hdl.handle.net/10230/42999
http://dx.doi.org/10.1093/ckj/sfy115
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Clinical Kidney Journal. 2018 Dec 1;12(4):586-91
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812455

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