a-standardized-porcine-kidney-auto-transplant-protocol-for-studying

A Standardized Porcine Kidney Auto-transplant Protocol for Studying Delayed Graft Function

Delayed graft function (DGF) is commonly defined as the need for dialysis within 7 days after kidney transplantation; however, current definitions often ...

Duke University

Conventional immunosuppressive regimens in kidney transplantation continue to pose significant challenges, largely due to their reliance on calcineurin inhibitors (CNIs) and corticosteroids. These challenges have driven the search for alternative regimens to minimize toxicity and preserve long-term graft function. In this study, we present real-world data utilizing a CNI-free regimen that makes use of the synergistic effects of costimulation blockade and mTOR inhibition. We retrospectively analyzed 106 kidney recipients from 2016 to 2024 who received alemtuzumab induction, followed by de novo belatacept and sirolimus maintenance therapy (alemtuzumab, belatacept, rapamycin regimen). Patient and graft survival were 100% at 1 year and 96% and 97% respectively, at 5 years. At 3 and 5 years, median glomerular filtration rate was 64 mL/min/1.73 m (interquartile range 54-75) and 62 mL/min/1.73 m (interquartile range 54-74), respectively. The rate of rejection in the first year was 6.6%. Ninety-six patients (91%) avoided treatment with CNIs during the follow-up period. Alemtuzumab and belatacept were well tolerated, but 44% of patients discontinued sirolimus, typically due to sirolimus-related side effects remedied with conversion to mycophenolate and prednisone. These results inform and support the study of the alemtuzumab, belatacept, rapamycin protocol, or similar costimulation blockade-based regimens, in pursuit of non-CNI-based therapies for kidney transplant recipients.

Off-label use of alemtuzumab, belatacept, and rapamycin in kidney transplantation-Long-term real-world experience.

Is New Always Better: Assessing New Hiatal Hernia Repairs.

Tracheobronchoplasty for Excessive Dynamic Airway Collapse and Tracheobronchomalacia: Different Diseases, Similar Outcomes.

Persistent inequities in lung transplant access arise from biologic constraints, geographic variation, and system-level practices that are not fully addressed by urgency-based allocation alone. The recent implementation of continuous distribution and the Composite Allocation Score (CAS) represent a major policy shift intended to improve fairness and transparency in lung allocation. This review examines whether early evidence supports these goals and identifies remaining challenges.

Article	Year
Off-label use of alemtuzumab, belatacept, and rapamycin in kidney transplantation-Long-term real-world experience. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons\| PubMed ID: 40945861	2026
Is New Always Better: Assessing New Hiatal Hernia Repairs. The Annals of thoracic surgery\| PubMed ID: 40975196	2025
Tracheobronchoplasty for Excessive Dynamic Airway Collapse and Tracheobronchomalacia: Different Diseases, Similar Outcomes. The Annals of thoracic surgery\| PubMed ID: 41043763	2025
Improving equity of access/transparency in organ allocation. Current opinion in pulmonary medicine\| PubMed ID: 41664501	2026
Research Highlights. Transplantation\| PubMed ID: 41784435	2026

Kateryna Krynychka

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