{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:47:39Z","timestamp":1787014059794,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Belatacept use in renal transplant is associated with similar graft survival and elimination of preexisting donor\u2010specific antibodies (DSA). We aim to describe the impact of Belatacept use on de novo DSA in lung transplant (LTx).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multi\u2010institutional retrospective review of LTx patients with de novo DSA who received Belatacept (January 2018\u2013August 2023) was performed. The primary outcome is the change in DSA post Belatacept initiation. Changes in mean fluorescence intensity (MFI) before and after Belatacept administration were analyzed using a linear mixed\u2010effects model. Secondary outcomes included antibody\u2010mediated rejection (AMR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010four patients with DSA received Belatacept. Most DSA were class II (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a041, 93%), with a median (IQR) MFI of 4000 (2500\u20137000) at Belatacept initiation. Following Belatacept initiation, DSA resolved in (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a025, 57%) patients, decreased in (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a07, 16%), and remained unchanged in (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a012, 27%). No de novo DSA developed during Belatacept therapy. There was no significant change in MFI pre Belatacept administration (change\u00a0=\u00a0\u221238, 95% CI: \u2212267 to 191,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.745), whereas MFI decreased significantly post Belatacept administration (change\u00a0=\u00a0\u2212334, 95% CI: \u2212449 to \u2212219,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). A total of (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a025, 57%) patients experienced AMR prior to initiating Belatacept. None of the patients developed AMR while on Belatacept.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This is the largest cohort to date of LTx patients with DSA who received Belatacept. Belatacept use was associated with a reduction in DSA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70415","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T14:37:13Z","timestamp":1765377433000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Belatacept\u2010Based Immunosuppression and Donor\u2010Specific Antibodies in Lung Transplant: A Multi\u2010Institutional Retrospective Study"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4357-1666","authenticated-orcid":false,"given":"Moustafa","family":"Younis","sequence":"first","affiliation":[{"name":"Division of Pulmonary Critical Care and Sleep Medicine Department of Medicine University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I.","family":"Mederos","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Critical Care and Sleep Medicine Department of Medicine University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecelia. M.","family":"Miller","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Critical Care and Sleep Medicine Department of Medicine University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Department of Medicine UT Southwestern  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariana","family":"Ishaq","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Department of Medicine UT Southwestern  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Mu","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Department of Medicine UT Southwestern  Dallas Texas 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