(1201) Belatacept as a Novel Pharmacological Strategy to Preserve Renal Function without Allograft Dysfunction

PurposeLung transplantation (LT) relies heavily on calcineurin inhibitors for the prevention of rejection but they can lead to chronic kidney dysfunction. The use belatacept has been reported stabilize renal function in some cases and small series LT recipients (LTRs). We aimed describe our experience using as a pharmacological strategy preserve without allograft dysfunction larger cohort LTRs.MethodsAfter IRB approval, we queried institutional database clinical data outcomes from LTRs who received at least 1 dose between September 2019 August 2022. Patients were followed clinically with laboratory tests month after initiation, every 3 months during first year, then 6 months. Analyzed included changes lung function.ResultsThirty-seven included; median age was 67 years (IQR 63-70). Indications restrictive disease (n=16; 43.2%) obstructive (n=14; 37.8%). indications sparing (n=35) thrombotic microangiopathies (n=2). time initiation 166 days 166-824) LT. Before after, 12 serum creatinine (mg/dL)/glomerular filtration (ml/min/1.73 m2) levels 2.11/29, 1.9/34, 2.21/33, respectively. Graft remains, FEV1 2.05L month, 2.12L months, 2.03L There no acute cellular rejections episodes within year starting belatacept.ConclusionThe creatine concentration stabilized graft most patients initiation. Our ongoing analyses include identification leukopenia, infections, de novo neoplasms same cohort; suggest that leukopenia is frequent side effect necessitating medication valganciclovir mycophenolic acid. Lung LTRs. After function. Thirty-seven belatacept.