Belatacept and Basiliximab in Intestinal Transplantation

Vrakas, Georgios; Weißenbacher, Annemarie; Chen, Mian; Allan, Philip; Smith, A. D.; Turkmen, Karen; Holdaway, L; Fuggle, Susan V.; Reddy, Shabashini; Friend, Peter J.

doi:10.1097/01.tp.0000521282.83986.56

Cited by 3 publications

(5 citation statements)

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“…In intestinal transplantation , in the setting of MPA‐associated gastrointestinal toxicities, azathioprine use has been reported in a case series with documented amelioration of gastrointestinal symptoms 150 . Its use was also described in a case series where azathioprine was used along with belatacept and prednisone as a rescue therapy in setting of tacrolimus associated kidney dysfunction 194 …”

Section: Clinical Questions and Recommendationsmentioning

confidence: 99%

“…150 Its use was also described in a case series where azathioprine was used along with belatacept and prednisone as a rescue therapy in setting of tacrolimus associated kidney dysfunction. 194 Azathioprine has been associated with less GI side effects compared to MMF in heart transplant. Specifically, in a 3-year, randomized, double-blind trial comparing MMF or AZA in combination with cyclosporine and corticosteroids, MMF showed a higher incidence of diarrhea (52.4% vs. 39.4%) and esophagitis (9% vs. 3.8%).…”

Section: Recommendation 8 Evidence Summary: Role Of Azathioprinementioning

confidence: 99%

“…109,231,234,235 In intestinal transplantation, corticosteroids are a standard component of early-and long-term M-IMS regimens as illustrated by observational studies that persistently include them as essential components of M-IMS in this population. 51,52,[54][55][56][150][151][152][153]194,[243][244][245][246] In heart transplantation, most patients are either maintained on corticosteroids or withdrawal is attempted at 3-6 months or greater post-transplant. [247][248][249][250][251][252] At 1 and 5 years post-transplant, 89% and 52% of recipients, respectively, continued to be maintained on corticosteroids.…”

Section: Recommendation 9 Evidence Summary: Corticosteroid Withdrawalmentioning

confidence: 99%

“…In intestinal transplantation , corticosteroids are a standard component of early‐ and long‐term M‐IMS regimens as illustrated by observational studies that persistently include them as essential components of M‐IMS in this population 51,52,54–56,150–153,194,243–246 …”

Section: Clinical Questions and Recommendationsmentioning

confidence: 99%

“…Intestine transplant data are limited to a single‐center report presented as an abstract during the 2017 International Congress of the Intestinal Rehabilitation and Transplant Association 194 . In a small cohort of six intestine transplant recipients on tacrolimus monotherapy experiencing CNI nephrotoxicity, patients were switched to either belatacept with azathioprine and prednisolone ( n = 2), low dose tacrolimus (levels < 3; n = 2), or no other maintenance therapy ( n = 2).…”

Section: Clinical Questions and Recommendationsmentioning

confidence: 99%

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Consensus recommendations for use of maintenance immunosuppression in solid organ transplantation: Endorsed by the American College of Clinical Pharmacy, American Society of Transplantation, and the International Society for Heart and Lung Transplantation

et al. 2022

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Advances in maintenance immunosuppression over the past three decades have improved solid organ transplantation outcomes dramatically. Uninterrupted access to immunosuppression is paramount to minimize rejection and maintain allograft and patient survival. There is no standardized approach to maintenance immunosuppression management. Agents used vary based on transplanted organ, center‐specific protocol, provider expertise, insurance formularies, ability to cover co‐pays, recipient characteristics and tolerability. Published data reflects this heterogeneity. Despite this limitation, maintenance immunosuppression usage cross pollinates between organ groups with standard of care agents often being used off‐label, making medication access a challenge for many transplant recipients. A multidisciplinary panel of American transplant clinicians was formed to review published literature on maintenance immunosuppression with the goal to formulate consensus recommendations for their use in specific organ groups. These consensus recommendations are intended to provide transplant clinicians with a summary of literature on maintenance immunosuppression in the modern era and to support transplant team members working to secure medication access for patients.

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Section: Clinical Questions and Recommendationsmentioning

confidence: 99%

Section: Recommendation 8 Evidence Summary: Role Of Azathioprinementioning

confidence: 99%