Costimulatory Blockade and Solid Organ Transplantation: The Past, Present, and Future

Exploring Costimulatory Blockade-Based Immunologic Strategies in Transplantation: Are They a Promising Immunomodulatory Approach for Organ and Vascularized Composite Allotransplantation?

“…Belatacept, a unique FDA-approved co-stimulation inhibitor, offers a novel approach to immunosuppression in solid organ transplantation, particularly in kidney transplantation. Unlike traditional immunosuppressants that target T cells directly, belatacept inhibits T cell activation by blocking co-stimulatory signals necessary for their activation [ 41 , 125 ].…”

“…Belatacept (LEA29Y) represents an alternative to abatacept, the difference being its higher affinity for target receptors and higher potency [ 41 , 66 , 67 ].…”

“…Table 1. A review of the costimulatory molecules classification according to their structure, in four major groups (families): [34][35][36][38][39][40][41][42][43][44][45][46][47][48][49]. CD28 represents the main costimulatory receptor of the B7 family.…”

An Unexpectedly High Incidence of Invasive Fungal Diseases in Solid Organ Transplant Recipients Taking Belatacept for Organ Rejection Prophylaxis: A Single-Center Retrospective Cohort Study

“…Belatacept was initially approved for organ rejection prophylaxis in kidney recipients and has become an essential alternative to calcineurin inhibitors (CNIs), given its lower risk of nephrotoxicity, decreased pill burden, and lack of therapeutic monitoring [ 3 , 4 ]. Other organ programs are now adopting belatacept for similar reasons, in addition to its benefits in recipients who are highly sensitized [ 5–7 ].…”