Transplant Trial Watch

Belatacept rescue therapy of CNI-induced nephrotoxicity, meta-analysis.

El Hennawy, H., et al.

Transplantation Reviews 2021; 35(4): 100653.

This study aimed to investigate the effect of calcineurin inhibitors (CNIs) conversion to belatacept on renal function in kidney transplant recipients.

An electronic database search was conducted on PubMed, the Cochrane library, Embase, Scopus, Web of Science, Google Scholar, the clinical trials, and the International Standard Randomized Controlled Trial Number registries. The titles and abstracts were screened by at least two reviewers. The risk of bias was assessed using the ROBINS-I tool.

13 studies were included in the review.

The main outcome of interest was renal function.


CET Conclusions
The systematic review and meta-analysis evaluated kidney function before and after conversion from calcineurin inhibitors (CNIs) to belatacept in kidney transplant recipients. Several bibliographic databases were searched but no search dates were reported. Independent reviewers screened the references and agreed on the studies for inclusion. It was not described whether data extraction and risk of bias assessment of non-randomised studies was also done by independent reviewers or how risk of bias of the single randomised controlled trial (RCT) was assessed. Thirteen studies were included and about half of these were assessed as having serious or critical risk of bias. Meta-analysis included 11 studies, and showed a statistically significant improvement of eGFR after conversion to belatacept but heterogeneity was high. After removal of one study, heterogeneity was still moderate but the authors did not attempt to explore heterogeneity further.

Trial registration

Funding source
Not reported