Blood Pressure and Graft Outcome in Renal Transplantation

Berber, İbrahim; Aydın, Çiğdem; Yiğit, Bülent; Kara, V. Melih; Yildar, Murat; Düzyol, Çağrı; Türkmen, F; Titiz, M.I.; Altaca, G

doi:10.1016/j.transproceed.2005.01.021

Cited by 16 publications

(9 citation statements)

References 10 publications

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“…The consequences of hypertension are serious and include poorer renal function (39) and diminished patient/graft survival (40,41). For example, a retrospective analysis of kidney transplant patients found that each 10 mm Hg increase in posttransplant systolic blood pressure was associated with a 10% to 20% increased risk for graft failure and death (12).…”

Section: Discussionmentioning

confidence: 99%

Belatacept-Based Regimens Are Associated With Improved Cardiovascular and Metabolic Risk Factors Compared With Cyclosporine in Kidney Transplant Recipients (BENEFIT and BENEFIT-EXT Studies)

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Belatacept-Based Regimens Are Associated With Improved Cardiovascular and Metabolic Risk Factors Compared With Cyclosporine in Kidney Transplant Recipients (BENEFIT and BENEFIT-EXT Studies)

et al. 2011

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“…The acute rejection rates were similar between the belatacept and cyclosporine groups, despite the use of lymphocyte-depleting agents to treat DGF in the cyclosporine group. The increased risk of graft failure associated with extended criteria donor kidneys reinforces the importance of evaluating calcineurin-avoiding regimens for potential preservation of renal function (5,(30)(31)(32).…”

Section: Safetymentioning

confidence: 99%

Phase III Study of Belatacept Versus Cyclosporine in Kidney Transplants from Extended Criteria Donors (BENEFIT‐EXT Study)

Dürrbach

Pestana

Pearson

et al. 2010

American Journal of Transplantation

498

554

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Recipients of extended criteria donor (ECD) kidneys are at increased risk for graft dysfunction/loss, and may benefit from immunosuppression that avoids calcineurin inhibitor (CNI) nephrotoxicity. Belatacept, a selective costimulation blocker, may preserve renal function and improve long-term outcomes versus CNIs. BENEFIT-EXT (Belatacept Evaluation of Nephroprotection and Efficacy as First-line Immunosuppression Trial-EXTended criteria donors) is a 3-year, Phase III study that assessed a more (MI) or less intensive (LI) regimen of belatacept versus cyclosporine in adult ECD kidney transplant recipients. The coprimary endpoints at 12 months were composite patient/graft survival and a composite renal impairment endpoint. Patient/graft survival with belatacept was similar to cyclosporine (86% MI, 89% LI, 85% cyclosporine) at 12 months. Fewer belatacept patients reached the composite renal impairment endpoint versus cyclosporine (71% MI, 77% LI, 85% cyclosporine; p = 0.002 MI vs. cyclosporine; p = 0.06 LI vs. cyclosporine). The mean measured glomerular filtration rate was 4-7 mL/min higher on belatacept versus cyclosporine (p = 0.008 MI vs. cyclosporine; p = 0.1039 LI vs. cyclosporine), and the overall cardiovascular/metabolic profile was better on belatacept versus cyclosporine. The incidence of acute rejection was similar across groups (18% MI; 18% LI; 14% cyclosporine). Overall rates of infection and malignancy were similar between groups; however, more cases of posttransplant lymphoproliferative disorder (PTLD) occurred in the CNS on belatacept. ECD kidney transplant recipients treated with belatacept-based immunosuppression achieved similar patient/graft survival, better renal function, had an increased incidence of PTLD, and exhibited improvement in the cardiovascular/metabolic risk profile versus cyclosporine-treated patients.

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“…In addition, since calcineurin inhibitors affect a broad range of nonimmunologic targets, they are associated with worsening hypertension (5), diabetes (6,7) and dyslipidemia (8), which can contribute to increased cardiovascular morbidity and mortality (9)(10)(11)(12)-the most common cause of death among transplant recipients 1 year posttransplant (13,14). The current long-term outcomes in renal transplant recipients indicate a need for selective immunosuppressants that may improve long-term patient and allograft survival by avoiding the chronic toxicities of nonselective immunosuppressive therapies.…”

Section: Introductionmentioning

confidence: 99%

A Phase III Study of Belatacept‐based Immunosuppression Regimens versus Cyclosporine in Renal Transplant Recipients (BENEFIT Study)

Vincenti

Charpentier

Vanrenterghem³

et al. 2010

American Journal of Transplantation

848

891

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Blood Pressure and Graft Outcome in Renal Transplantation

Cited by 16 publications

References 10 publications

Belatacept-Based Regimens Are Associated With Improved Cardiovascular and Metabolic Risk Factors Compared With Cyclosporine in Kidney Transplant Recipients (BENEFIT and BENEFIT-EXT Studies)

Belatacept-Based Regimens Are Associated With Improved Cardiovascular and Metabolic Risk Factors Compared With Cyclosporine in Kidney Transplant Recipients (BENEFIT and BENEFIT-EXT Studies)

Phase III Study of Belatacept Versus Cyclosporine in Kidney Transplants from Extended Criteria Donors (BENEFIT‐EXT Study)

A Phase III Study of Belatacept‐based Immunosuppression Regimens versus Cyclosporine in Renal Transplant Recipients (BENEFIT Study)

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