{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T02:19:15Z","timestamp":1789265955911,"version":"build-2803163510"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n            <jats:title>Background.<\/jats:title>\n            <jats:p>The efficacy and safety of belatacept when converted from calcineurin inhibitors (CNI) in HLA-sensitized (HS) kidney transplant recipients has not been established.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods.<\/jats:title>\n            <jats:p>The study included 108 kidney transplant recipients converted from CNI to belatacept between July 1, 2012, and September 30, 2017. Rejection-free, patient, and graft survival over 5 years follow-up were compared between HS and non-HLA-sensitized (non-HS) recipients using the Kaplan-Meier product-limit method. The estimated glomerular filtration rate slope postconversion was compared using linear mixed effects models.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results.<\/jats:title>\n            <jats:p>There were 29 HS and 79 non-HS recipients included. Rejections after conversion were mostly cell-mediated. There was no difference in rejection-free survival (log-rank <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.30; at 5 y, HS: 82%; non-HS: 84.6%); however, rejection-free survival was lower among HS recipients converted within the first-year posttransplant compared to non-HS recipients (log-rank <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.03; at 5 y, HS: 55.6%; non-HS: 75.0%). There was no difference in patient survival (log-rank <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.75; at 5 y, HS: 85.7%, non-HS: 83.7%) or graft survival (log-rank <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.17; at 5 y, HS: 78.5%, non-HS: 89.8%) in the 2 groups. On average, estimated glomerular filtration rate slope improved postconversion in non-HS (0.28\u2009mL\/min\/1.73 m<jats:sup>2<\/jats:sup>\/y [0.03 to 0.53]) but declined in HS recipients (-0.44\u2009mL\/min\/1.73 m<jats:sup>2<\/jats:sup>\/y [-0.85 to -0.03]).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions.<\/jats:title>\n            <jats:p>There was no difference in rejection-free, patient, or graft survival after conversion to belatacept over 5 years among HS and non-HS recipients. However, rejection-free survival was lower in HS recipients converted to belatacept within the first-year posttransplant. Conversion from CNI to belatacept should be done cautiously in high immunologic risk patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/tp.0000000000002976","type":"journal-article","created":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T09:12:22Z","timestamp":1568970742000},"page":"1500-1507","source":"Crossref","is-referenced-by-count":17,"title":["Outcomes of Conversion From Calcineurin Inhibitor to Belatacept-based Immunosuppression in HLA-sensitized Kidney Transplant Recipients"],"prefix":"10.1097","volume":"104","author":[{"given":"Supreet","family":"Sethi","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Comprehensive Transplant Center, Cedars Sinai Medical Center, West Hollywood, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reiad","family":"Najjar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Comprehensive Transplant Center, Cedars Sinai Medical Center, West Hollywood, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Comprehensive Transplant Center, Cedars Sinai Medical Center, West Hollywood, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jua","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Comprehensive Transplant Center, Cedars Sinai Medical Center, West Hollywood, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathlyn","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Comprehensive Transplant Center, Cedars Sinai Medical Center, West Hollywood, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Vo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Comprehensive Transplant Center, Cedars Sinai Medical Center, West Hollywood, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley C.","family":"Jordan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Comprehensive Transplant Center, Cedars Sinai Medical Center, West Hollywood, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmund","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Comprehensive Transplant Center, Cedars Sinai Medical Center, West Hollywood, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,9,19]]},"reference":[{"key":"R1-20231002","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1111\/j.1600-6143.2005.00749.x","article-title":"Rational development of LEA29Y (belatacept), a high-affinity variant of CTLA4-Ig with potent 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groups.","volume":"10","author":"Sis","year":"2010","journal-title":"Am J Transplant"},{"key":"R12-20231002","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1111\/ajt.12590","article-title":"Banff 2013 meeting report: inclusion of c4d-negative antibody-mediated rejection and antibody-associated arterial lesions.","volume":"14","author":"Haas","year":"2014","journal-title":"Am J Transplant"},{"key":"R13-20231002","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1681\/ASN.2017060679","article-title":"Control of humoral response in renal transplantation by belatacept depends on a direct effect on B cells and impaired T follicular helper-B cell crosstalk.","volume":"29","author":"Leibler","year":"2018","journal-title":"J Am Soc Nephrol"},{"key":"R14-20231002","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1111\/ajt.12721","article-title":"Kidney transplant recipients treated with belatacept exhibit increased na\u00efve and transitional B cells.","volume":"14","author":"Leibler","year":"2014","journal-title":"Am J Transplant"},{"key":"R15-20231002","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/j.1600-6143.2011.03762.x","article-title":"Integrin antagonists prevent costimulatory blockade-resistant transplant rejection by CD8(+) memory T cells.","volume":"12","author":"Kitchens","year":"2012","journal-title":"Am J Transplant"},{"key":"R16-20231002","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1111\/ajt.12600","article-title":"High CTLA-4 expression on Th17 cells results in increased sensitivity to CTLA-4 coinhibition and resistance to belatacept.","volume":"14","author":"Krummey","year":"2014","journal-title":"Am J Transplant"},{"key":"R17-20231002","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1111\/ajt.15229","article-title":"Belatacept in renal transplant recipient with mild immunologic risk factor: a pilot prospective study (BELACOR).","volume":"19","author":"Leibler","year":"2019","journal-title":"Am J Transplant"},{"key":"R18-20231002","doi-asserted-by":"crossref","first-page":"430","DOI":"10.2215\/CJN.05840710","article-title":"Switching from calcineurin inhibitor-based regimens to a belatacept-based regimen in renal transplant recipients: a randomized phase II study.","volume":"6","author":"Rostaing","year":"2011","journal-title":"Clin J Am Soc Nephrol"},{"key":"R19-20231002","doi-asserted-by":"crossref","first-page":"2726","DOI":"10.1111\/ajt.13322","article-title":"Safe conversion from tacrolimus to belatacept in high immunologic risk kidney transplant recipients with allograft dysfunction.","volume":"15","author":"Gupta","year":"2015","journal-title":"Am J Transplant"},{"key":"R20-20231002","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1097\/TP.0000000000002192","article-title":"Conversion to belatacept in maintenance kidney transplant patients: a retrospective multicenter European 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