Belatacept Conversion in an HIV Positive Kidney Transplant Recipient with Prolonged Delayed Graft Function

Abstract

We report an HIV renal transplant recipient with delayed graft function who was converted from tacrolimus to belatacept, in an attempt to improve renal function. The patient had kidney biopsies at four and eight weeks post-transplant that revealed acute tubular necrosis and mild fibrosis. After 14 weeks of delayed function belatacept was initiated and tacrolimus was weaned off. Shortly after discontinuing tacrolimus renal function began to improve. The patient was able to discontinue dialysis 21 weeks post- transplant. HIV viral load was undetectable at last follow up. To our knowledge this is the first report of belatacept use in an HIV patient.

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