{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:46:41Z","timestamp":1790192801803,"version":"4.1.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontierspartnerships.org"],"crossmark-restriction":true},"short-container-title":["Transpl Int"],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> The long-term benefits of conversion from calcineurin inhibitors (CNIs) to belatacept in kidney transplant recipients (KTr) are poorly documented<jats:italic>.<\/jats:italic><\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A single-center retrospective work to study first-time CNI to belatacept conversion as a rescue therapy [eGFR &amp;lt;30\u00a0ml\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup>, chronic histological lesions, or CNI-induced thrombotic microangiopathy (TMA)]. Patient and kidney allograft survivals, eGFR, severe adverse events, donor-specific antibodies (DSA), and histological data were recorded over 36\u00a0months after conversion.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> We included N = 115 KTr. The leading cause for switching was chronic histological lesions with non-optimal eGFR (56.5%). Three years after conversion, patient, and death-censored kidney allograft survivals were 88% and 92%, respectively, eGFR increased significantly from 31.5 \u00b1 17.5 to 36.7 \u00b1 15.7\u00a0ml\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup> (<jats:italic>p<\/jats:italic> &amp;lt; 0.01), the rejection rate was 10.4%, OI incidence was 5.2 (2.9\u20137.6) per 100 person-years. Older age was associated with death, eGFR was not associated with death nor allograft loss. No patient developed <jats:italic>dn<\/jats:italic>DSA at M36 after conversion. CNI-induced TMA disappeared in all cases without eculizumab use. Microvascular inflammation and chronic lesions remained stable.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Post-KT conversion from CNIs to belatacept, as rescue therapy, is safe and beneficial irrespective of the switch timing and could represent a good compromise facing organ shortage. Age and eGFR at conversion should be considered in the decision whether to switch.<\/jats:p>","DOI":"10.3389\/ti.2022.10228","type":"journal-article","created":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T09:35:46Z","timestamp":1652175346000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Three-Year Outcomes in Kidney Transplant Recipients Switched From Calcineurin Inhibitor-Based Regimens to Belatacept as a Rescue 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