Efficacy and Safety Outcomes of Extended Criteria Donor Kidneys by Subtype: Subgroup Analysis of BENEFIT-EXT at 7 Years After Transplant

S. Florman, T. Becker, B. Bresnahan, A. Chevaile-Ramos, D. Carvalho, G. Grannas, F. Muehlbacher, P. J. O'Connell, H. U. Meier-Kriesche, C. P. Larsen

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

The phase III Belatacept Evaluation of Nephroprotection and Efficacy as First-Line Immunosuppression Trial–Extended Criteria Donors Trial (BENEFIT-EXT) study compared more or less intensive belatacept-based immunosuppression with cyclosporine (CsA)–based immunosuppression in recipients of extended criteria donor kidneys. In this post hoc analysis, patient outcomes were assessed according to donor kidney subtype. In total, 68.9% of patients received an expanded criteria donor kidney (United Network for Organ Sharing definition), 10.1% received a donation after cardiac death kidney, and 21.0% received a kidney with an anticipated cold ischemic time ≥24 h. Over 7 years, time to death or graft loss was similar between belatacept- and CsA-based immunosuppression, regardless of donor kidney subtype. In all three donor kidney cohorts, estimated mean GFR increased over months 1–84 for belatacept-based treatment but declined for CsA-based treatment. The estimated differences in GFR significantly favored each belatacept-based regimen versus the CsA-based regimen in the three subgroups (p < 0.0001 for overall treatment effect). No differences in the safety profile of belatacept were observed by donor kidney subtype.

Original languageEnglish
Pages (from-to)180-190
Number of pages11
JournalAmerican Journal of Transplantation
Volume17
Issue number1
DOIs
StatePublished - 1 Jan 2017

Keywords

  • calcineurin inhibitor: cyclosporine A (CsA)
  • clinical research/practice
  • donors and donation: deceased
  • donors and donation: donation after circulatory death (DCD)
  • donors and donation: extended criteria
  • immunosuppressant
  • kidney transplantation/nephrology

Fingerprint

Dive into the research topics of 'Efficacy and Safety Outcomes of Extended Criteria Donor Kidneys by Subtype: Subgroup Analysis of BENEFIT-EXT at 7 Years After Transplant'. Together they form a unique fingerprint.

Cite this