AUTHOR=Bertrand Dominique , Brunel Mélanie , Lebourg Ludivine , Scemla Anne , Lemoine Mathilde , Amrouche Lucile , Laurent Charlotte , Legendre Christophe , Guerrot Dominique , Anglicheau Dany , Sberro-Soussan Rebecca 

TITLE=Conversion From Intravenous In-Hospital Belatacept Injection to Subcutaneous Abatacept Injection in Kidney Transplant Recipients During the First COVID-19 Stay-at-Home Order in France

JOURNAL=Transplant International

VOLUME=Volume 36 - 2023

YEAR=2023

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2023.11328

DOI=10.3389/ti.2023.11328

ISSN=1432-2277

ABSTRACT=The first COVID-19 stay-at-home order became effective in France on March 17, 2020. Immunocompromised patients were asked to stay confined and outpatient clinic visits were dramatically reduce. In order to avoid belatacept treated kidney transplant recipients (KTR) visits to the hospital during the initial pandemic period, we promptly converted 176 KTR from once monthly 5 mg/kg in-hospital belatacept infusion to once weekly 125 mg subcutaneous abatacept injection, in two French transplant centers. At the end of follow-up (3 months), 171 (97.16%) KTRs survived with a functioning graft, 2 (1.14%) died and 3 (1.70%) experienced graft loss. Two patients (1.1%) experienced an acute T cell mediated rejection. Nineteen (10.80%) patients discontinued abatacept; 47 % of the KTR found the use of abatacept less restrictive than belatacept and 38% would have preferred continue abatacept.  Mean eGFR remained stable compared with baseline. Seven patients (3.9%) had COVID-19 and among them, two developed severe symptoms but survived. Only one had a de novo DSA. Side effects of abatacept injection were uncommon and non-severe. Our study reported for the first time in a large cohort that once weekly injection of abatacept seems feasible and safe in KTR previously treated by belatacept.