{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:57:52Z","timestamp":1790837872345,"version":"4.1.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,2,1]],"date-time":"2020-02-01T00:00:00Z","timestamp":1580515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Belatacept (bela) rescue therapy seems to be a valuable option for calcineurin inhibitor chronic toxicity in kidney transplantation. Nevertheless, the risk of infection associated with bela is not well reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We report the rate of opportunistic infections (OPI) after a switch to bela in a multicentric cohort of 280 kidney transplant patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Forty-two OPI occurred in 34 patients (12.1%), on average 10.8\u2009\u00b1\u200911.3\u2009months after the switch. With a cumulative exposure of 5128\u2009months of bela treatment, we found an incidence of 0.008 OPI\/month of exposure, and 9.8 OPI\/100 person-years. The most common OPI was cytomegalovirus (CMV) disease in 18\/42 OPI (42.9%) and pneumocystis pneumonia in 12\/42 OPI (28.6%). Two patients presented a progressive multifocal leucoencephalopathy and two patients developed a cerebral Epstein\u2013Barr virus-induced post-transplant lymphoproliferative disease. OPI led to death in 9\/34 patients (26.5%) and graft failure in 4\/34 patients (11.8%). In multivariate analysis, estimated glomerular filtration rate\u2009&amp;lt;25\/mL\/min\/1.73\u2009m2 on the day of the switch and the use of immunosuppressive agents before transplantation were associated with the occurrence of OPI. We found a higher rate of infection-related hospitalization (24.1 versus 12.3\/100 person-years, P\u2009=\u20090.0007) and also a higher rate of OPI (13.2 versus 6.7\/100 person-years, P\u2009=\u20090.005) in the early conversion group (within 6\u2009months).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The risk of OPI is significant post-conversion to bela and may require additional monitoring and prophylactic therapy, particularly regarding pneumocystis pneumonia and CMV disease. These data need to be confirmed in a larger case\u2013control study.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfz255","type":"journal-article","created":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T15:10:28Z","timestamp":1573657828000},"page":"336-345","source":"Crossref","is-referenced-by-count":79,"title":["Opportunistic infections after conversion to belatacept in kidney transplantation"],"prefix":"10.1093","volume":"35","author":[{"given":"Dominique","family":"Bertrand","sequence":"first","affiliation":[{"name":"Department of Nephrology, Rouen University Hospital, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Chavarot","sequence":"additional","affiliation":[{"name":"Department of Adult Kidney Transplantation, Necker-Enfants Malades University Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Gatault","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Tours University Hospital, Tours, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyril","family":"Garrouste","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Clermont Ferrand University Hospital, Clermont Ferrand, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Bouvier","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Caen University Hospital, Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Grall-Jezequel","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Brest University Hospital, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u00eft\u00e9","family":"Jaureguy","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Amiens University Hospital, Amiens, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Caillard","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Strasbourg University Hospital, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathilde","family":"Lemoine","sequence":"additional","affiliation":[{"name":"Department of Nephrology, European Georges Pompidou University Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Colosio","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Reims University Hospital, Reims, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e9onard","family":"Golbin","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rennes University Hospital, Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Philippe","family":"Rerolle","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Limoges University Hospital, Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Thierry","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Poitiers University Hospital, Poitiers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnny","family":"Sayegh","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Angers University Hospital, Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Etienne","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rouen University Hospital, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludivine","family":"Lebourg","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rouen University Hospital, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Sberro","sequence":"additional","affiliation":[{"name":"Department of Adult Kidney Transplantation, Necker-Enfants Malades University Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5953-5785","authenticated-orcid":false,"given":"Dominique","family":"Guerrot","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rouen University Hospital, Rouen, 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