The role of belataceptin transplantation: results and implications of clinical trials in the context of other new biological immunosuppressant agents


  • Conflict of interest: Uwe Heemann has received grants from Novartis, Roche, and Astellas, and is a member of scientific advisory boards for Novartis, Roche, Astellas, and Bristol-Myers Squibb. Ondrej Viklicky has received grants from Novartis and Amgen, and is a member of scientific advisory boards for Novartis, Genzyme, Pfizer, and Astellas.

Corresponding author: Uwe Heemann, Department of Nephrology, Klinikum rechts der Isar der, Technischen Universität München, Ismaninger Str. 22, 81675 München, Germany.

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Although conventional immunosuppressive agents such as calcineurin inhibitors, have substantially reduced the risk of acute rejection, they have had less impact on the long-term survival. This is likely to be related to the adverse effects of such agents in terms of impaired renal function, hypertension, and dyslipidemia. These pitfalls of the currently available agents stimulated the research for biologic agents. Several biologic agents are now in development and hold promise for improved long-term outcomes in renal transplant recipients, particularly in those who receive sub-optimal organs. This article gives an overview of these new biological agents with particular emphasis on belatacept and their possible impact on short- and long-term outcomes, notably on marginal organs.