Calcineurin inhibitors (CNIs) have been the backbone immunosuppressant for solid organ transplant recipients for decades. Long-term use of CNIs unfortunately is associated with multiple toxicities, with the biggest concern being CNI-induced nephrotoxicity. Belatacept is a novel agent approved for maintenance immunosuppression in renal transplant recipients. In the kidney transplant literature, it has shown promise as being an alternative agent by preserving renal function and having a minimal adverse effect profile. There are emerging studies of its use in other organ groups, particularly liver transplantation, as well as using with other alternative immunosuppressive strategies. The purpose of this review is to analyze the current literature of belatacept use in solid organ transplantation and discuss its use in current practice. Corresponding author: Caroline P. Perez, PharmD, BCPS, Clinical Pharmacy Specialist, Solid Organ Transplant, Medical University of South Carolina, 150 Ashley Avenue, MSC 584, Charleston, SC 29425. perezca@musc.edu Authorship contribution: All authors were involved with analyzing the literature, interpreting the data, and writing the manuscript. CP, NP, and NAP were involved with revising the manuscript. CP was involved with coordination and final editing of the manuscript. All authors agreed upon final approval of the version submitted. Disclosure: The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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