Belatacept as salvage maintenance immunosuppression in a liver transplant recipient

Kyle Lang, Clare Kane, Lisa B. VanWagner

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Belatacept is a novel fusion protein that blocks signal two of T cell activation. Belatacept was approved in 2015 for the prevention of acute rejection in kidney transplant recipients. Results from a 2014 phase II clinical trial in liver transplant recipients was terminated early due to an increased risk of death and graft loss, leading to a black box warning for its use in liver transplant recipients. Here we describe the clinical course of a 55 year old male patient who underwent a liver transplant for cholestatic liver disease. His post-transplant course was complicated by multiple episodes of severe acute cellular rejection as well as multiple complications from maintenance immunosuppression including chronic kidney disease (CKD), steroid-induced diabetes, mycophenolate-associated colitis, and mammalian target of rapamycin (mTOR) inhibitor-induced lung injury. Belatacept was initiated 5 years post-transplant as a last-line option for maintenance immunosuppression. Six months post-initiation, the patient has had stabilization of his CKD, improvement in lung function, and remains without evidence of acute or chronic rejection.

Original languageEnglish (US)
Article number100070
JournalTransplantation Reports
Issue number4
StatePublished - Dec 2020
Externally publishedYes


  • Acute cellular rejection
  • Belatacept
  • Chronic kidney disease in liver transplantation
  • Immunosuppression
  • Immunosuppression related adverse drug reactions
  • Liver transplantation
  • Mammalian target of rapamycin inhibitor-induced lung injury
  • Mycophenolate induced colitis

ASJC Scopus subject areas

  • Surgery
  • Transplantation


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