Octav Cristea’s research recognized with AST KPCOP Travel Grant
MAY 2020
Second year Emory transplant surgery fellow Octav Cristea, MD, received an American Society of Transplantation (AST) Kidney Pancreas Community of Practice (KPCOP) Travel Reimbursement Grant to fund his attendance of the 2020 American Transplant Congress. Since the physical congress was cancelled due to COVID-19, Dr. Crista received a plaque in lieu of travel expenses and presented his award-winning abstract at the ATC 2020 Virtual Congress.
The aim of Dr. Cristea's study was to evaluate Emory's kidney transplant patient population, the largest real-world group treated with belatacept, to determine the relationship between belatacept immunosuppresion, rejection, and emergence of donor-specific antibodies (DSAs).
Belatacept, developed by Emory transplant surgeon-scientists Christian Larsen, MD, DPhil, Thomas Pearson, MD, DPhil, and researchers at Bristol Myers Squibb as a less toxic alternative to standard immunosuppressants, has formed the backbone of kidney transplant recipients' immunosuppressive regimens at Emory since the drug received FDA approval in 2011. When compared to the more commonly used calcineurin inhibitors (CNI), belatacept has been shown to improve long-term graft function, decrease the risk of recipient death and graft loss, and to possibly lower the formation of DSAs, long considered one of the primary causes of ongoing damage to transplanted kidneys following an initial rejection episode.
Dr. Cristea and his team, which included Dr. Larsen, Dr. Cristea's mentor and transplant surgeon-immunologist I. Raul Badell, MD, and research informatics specialist Geeta Karadkhele, analyzed 1509 transplants performed between June 2011 through December 2018. Of these patients, 992 received belatacept and 527 received CNIs. While the belatacept group had slightly higher rates of rejection (29.5% vs. 24.8%; P =0.049), which tended to be more severe when they did occur, DSA formation remained significantly lower in the belatacept group, both with rejection (25.5% vs. 33.6%; P=0.029) and without (4.% vs. 13.8%; P<0.001). Death rates and graft loss in the medium term were similar in both groups.
For Dr. Cristea and his team, these findings lend further weight to the hypothesis that the ability of belatacept to inhibit DSA formation may be responsible for some of the long-term benefits observed with the drug in clinical trials.