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Co Stimulation Blockade and The Allograft

Co Stimulation Blockade and The Allograft



A nice review of this new agent in Transplantation

A nice review of this new agent in Transplantation



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  • Although hyperacute rejection is also Ab mediated it differs from Ab mediated vascular rejection as it does not have an inflammatory or fibrinoid component at its outset.
  • Staining for complement component C4d C4d was first recognized in early 90’s and subsequently linked to presence of DSA and humoral rejection DSA directly engages HLA antigens present in glomerulus as well as PTC therefore cause of specificity remains unknown
  • C4d even though catalytically inactive but does interact with ____________to regulate humoral responses
  • Seen in many places for example in lungs of patients who succumb to H1N1 influenza infection
  • Last line…..suggesting that C4d is a MARKER OF CLINICALLY RELEVANT HUMORAL INJURY
  • 1.arterial inflammation in classic vascular AMR may be indistinguishable from ----2. Effects of vascular occlusion,infarction and hmgh may be a manifestation of ----
  • Selective IA not available in US is an attractive alternative to nonselective combination of IVIG and Plasmapheresis This may be a reason why some cases of mild AMR respond to therapies targeting cellular rejection
  • Need to pherese is determined based on -----
  • Total of 3 years to evaluate the long term safety and efficacy of Belatacept based regimen ECD-donors ≥60 years old; donors ≥50 years old who had at least two otherrisk factors (cerebrovascular accident, hypertension and serum creatinine>1.5 mg/dL); an anticipated cold ischemia time of ≥24 h; and donationafter cardiac death.
  • This was only one year follow up
  • Each dot represents an individual sample; some patientscontributed more than one sampleCD86 receptor saturation HIGHER in pts receiving Belatacept every 4 weeks

Co Stimulation Blockade and The Allograft Co Stimulation Blockade and The Allograft Presentation Transcript