Opportunistic infections after conversion to belatacept in kidney transplantation
Opportunistic infections after conversion to belatacept in kidney transplantation
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DOI：
10.1093/ndt/gfz255
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发表时间：
2020-02-01
影响因子：
6.1
通讯作者：
Guerrot, Dominique
中科院分区：
文献类型：
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作者：
Bertrand, Dominique;Chavarot, Nathalie;Guerrot, Dominique
背景：Belatacept(Bela)抢救疗法似乎是治疗钙调神经磷酸酶抑制剂在肾移植中的慢性毒性的有价值的选择。方法我们报道了280例肾移植患者转行BERA后的机会性感染(OPI)发生率。结果34例患者发生OPI(12.1%)，平均10.811.3个月。累积暴露5128个月的BELA治疗，我们发现发病率为0.008 OPI/月，9.8OPI/100人年。最常见的OPI是巨细胞病毒病(CMV)18/42(42.9%)，肺炎12/42(28.6%)。两名患者表现为进行性多灶性白质脑病，两名患者发展为脑部EB病毒引起的移植后淋巴增生性疾病。OPI死亡9/34例(26.5%)，移植物衰竭4/34例(11.8%)。在多变量分析中，估计的肾小球滤过率
Background Belatacept (bela) rescue therapy seems to be a valuable option for calcineurin inhibitor chronic toxicity in kidney transplantation. Nevertheless, the risk of infection associated with bela is not well reported.Methods We report the rate of opportunistic infections (OPI) after a switch to bela in a multicentric cohort of 280 kidney transplant patients.Results Forty-two OPI occurred in 34 patients (12.1%), on average 10.811.3months after the switch. With a cumulative exposure of 5128months of bela treatment, we found an incidence of 0.008 OPI/month of exposure, and 9.8 OPI/100 person-years. The most common OPI was cytomegalovirus (CMV) disease in 18/42 OPI (42.9%) and pneumocystis pneumonia in 12/42 OPI (28.6%). Two patients presented a progressive multifocal leucoencephalopathy and two patients developed a cerebral Epstein-Barr virus-induced post-transplant lymphoproliferative disease. OPI led to death in 9/34 patients (26.5%) and graft failure in 4/34 patients (11.8%). In multivariate analysis, estimated glomerular filtration rate