Nulojix (belatacept) / BMS - LARVOL DELTA

Systematic review of emerging technologies in vascularized composite allotransplantation. (PubMed, Front Transplant) - "Novel immunomodulation strategies including belatacept, phototherapy, siRNA therapeutics, and tolerance induction via regulatory T-cells show potential to reduce systemic immunosuppression, while mesenchymal stem cell approaches may increase graft tolerance...On a bigger scale, patient selection incorporating evidence-backed psychosocial factors and communication training work to address systems-level barriers to expand access. Ongoing research to translate these innovations into clinical practice will be important in realizing the potential of VCA."

Journal • Review • Cardiovascular • Immunology • Transplantation

Updates in pediatric kidney transplantation. (PubMed, Curr Opin Organ Transplant) - "Transplant teams should consider using a broader range of donor organs in select pediatric patients. Further interventional research on peritransplant thromboprophylaxis and fluid management is needed to optimize management strategies. The completion of ongoing belatacept and letermovir trials have the potential to substantially alter posttransplant standards of care."

Journal • Cytomegalovirus Infection • Nephrology • Pediatrics • Transplantation

Torque teno virus load and antiviral T-cell immune response after belatacept initiation in kidney transplant recipients (ESCMID Global 2026) - No abstract available

Clinical • Transplantation

Immunogenicity of the bivalent pre-F respiratory syncytial virus (RSV) vaccine in kidney transplant recipients with and without belatacept as maintenance immunosuppressive treatment (ESCMID Global 2026) - No abstract available

Clinical • Respiratory Diseases • Respiratory Syncytial Virus Infections • Transplantation

De novo belatacept does not reduce skin cancer incidence and burden in renal transplant recipients (AAD 2026) - "De novo belatacept maintenance therapy did not reduce incidence or burden of skin cancers in renal transplant recipients compared with calcineurin inhibitor regimens. Our findings suggest belatacept does not mitigate skin cancer risk, underscoring the need for regular dermatologic examination regardless of regimen."

Clinical • Genetic Disorders • Oncology • Skin Cancer • Squamous Cell Carcinoma • Transplantation

Belatacept Use in Pediatric Kidney Transplant Recipients: A Single-Center Case Series (PAS 2026) - No abstract available

Clinical • Pediatrics • Transplantation

Once-Daily Mammalian Target of Rapamycin Inhibition as an Alternative to Mycophenolic Acid in High-Risk Pediatric Kidney Transplant Recipients on Belatacept (PAS 2026) - No abstract available

Clinical • Pediatrics • Transplantation

Belatacept for calcineurin inhibitor-induced pain syndrome in a kidney transplant recipient. (PubMed, Clin Kidney J) - "The bone marrow edema also significantly improved on magnetic resonance imaging. Normal kidney functions were maintained on follow-up."

Journal • Immunology • Musculoskeletal Pain • Pain • Transplantation

Bilateral Native Kidney Embolization (NKE) after Kidney Transplant (KT) (NKF-SCM 2026) - "He had received thymoglobulin induction and a calneurin-inhibitor based regimen that was switched to Belatacept considering his persitent ATN...RESULTS/CASE DISCUSSION Our case highlights an out of the box approach to address the negative effects of residual kidney function with the use of stepwise NKE. This minimally invasive approach is proven to be a safe and effective alternative to extensive surgical interventions."

Autosomal Dominant Polycystic Kidney Disease • Cardiovascular • Chronic Kidney Disease • Genetic Disorders • Hypertension • Hypotension • Nephrology • Polycystic Kidney Disease • Transplantation

CD28 pathway blockade to transplant tolerance: Expanding the landscape of immune regulation. (PubMed, Curr Res Transl Med) - "Clinical experience with belatacept demonstrates superior long-term renal function compared with calcineurin inhibitors, although early rejection in select populations highlights the redundancy of costimulatory networks and the need for rational combination approaches. Next-generation agents-including selective CD28 antagonists, engineered biologics, and localized delivery platforms-further expand the therapeutic landscape, while biomarker-guided dosing and integration with regulatory T- and B-cell-based therapies offer opportunities for personalized tolerance induction. This review synthesizes mechanistic insights and clinical advances in CD28-directed costimulatory therapeutics and outlines how emerging agents, precision biomarkers, and regulatory-cell-centered strategies may be leveraged to achieve durable, organ-specific graft acceptance."

Journal • Review • Transplantation • CD80

Predictors of EBV Viremia in Belatacept Treated Heart Transplant Recipients (ISHLT 2026) - "Tacrolimus dosage was reduced, without significant changes in Prednisone and Mycophenolate (MMF). Patients aged >55y at transplant had significantly higher odds of viremia (OR 3.27, 95% CI: 1.19-8.96, p=0.011). There were no differences in Tacrolimus levels (p=0.79), MMF doses (p=0.54), diabetes (p=0.91), sex (p=0.36), age >55 at BTC initiation (p=0.30), rates of splenectomy, HIV or history of malignancy between patients who had viremia and those who did not.Conclusion We identified age at transplant >55 as an independent factor associated with EBV viremia post-BTC initiation in HT recipients."

Clinical • Diabetes • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders • Transplantation

A Case Of Graft Versus Host Disease In A Renal Transplant Recipient (NKF-SCM 2026) - "She underwent deceased donor kidney transplantation with Thymoglobulin induction therapy and co-stimulatory blockade with Belatacept.5 weeks post-transplant, she presented to the Emergency room with fevers accompanied by red, pruritic skin lesions on her neck, upper back, and upper extremities...The patient was started on Solumedrol 2mg/kg daily and underwent bone marrow biopsy, later confirming bone marrow involvement...Timely diagnosis and treatment are crucial as GVHD has increased morbidity and high mortality. This case highlights the unique challenges in diagnosing GVHD, and revisits induction immunosuppression agents, and their implications."

Clinical • Bone Marrow Transplantation • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Cutaneous Lupus Erythematosus • Febrile Neutropenia • Glomerulonephritis • Graft versus Host Disease • Heart Failure • Hematological Disorders • Hepatitis B • Hepatology • Immunology • Infectious Disease • Inflammation • Inflammatory Arthritis • Lupus • Lupus Nephritis • Nephrology • Neutropenia • Transplantation

Between a Heart and a Hard Node: A Difficult Case of Lymphadenopathy (ISHLT 2026) - "For immunosuppression, he was on belatacept, tacrolimus, mycophenolate, and prednisone...He was started on empiric mycobacterial treatment with intravenous amikacin, imipenem, linezolid, ethambutol, and rifabutin...He completed 4 weeks of ertapenem, and has continued on isavuconazole, azithromycin, ethambutol, rifabutin, and tedizolid.Summary This case highlights a challenging presentation of lymphadenopathy with B-symptoms initially concerning for PTLD but was found to have multiple infections. In immunosuppressed patients, overlapping infectious and noninfectious processes can complicate diagnosis. Obtaining comprehensive diagnostic evaluation is essential to identify the cause and initiate appropriate therapy for optimal outcomes."

Clinical • Cardiomyopathy • Cardiovascular • Infectious Disease • Pneumonia

Belatacept and Transcriptomic Immune Modulation in Heart Transplantation (ISHLT 2026) - "Covariate balance was achieved across all weighted variables (|SMD| < 0.21)Conclusion Belatacept use was independently associated with lower intra-graft TCMR-related molecular activity, without significant differences in injury, ABMR, or global activation domains. These findings provide preliminary molecular insights into the immune landscape of belatacept-treated HT and warrant confirmation in larger longitudinal studies"

Immune Modulation • Immunology • Transplantation

The Rise of DSA Without AMR: When and How to Intervene (ISHLT 2026) - "3) If treatment is pursued, which approach is most rational - anti-CD38 (daratumumab), co-stimulation blockade (belatacept), anti-IL-6 (tocilizumab), anti-CD20 (rituximab), or proteasome inhibition (bortezomib)? 4) Should maintenance immunosuppression be modified to prevent further antibody evolution? At the end of the talk there will be a vote for best treatment from the audience."

IO biomarker • Transplantation

First Reported Myeloid Sarcoma After Heart Transplantation Presenting as Fulminant Liver Failure (ISHLT 2026) - "Her immunosuppression protocol was belatacept, tacrolimus, and MMF...Given diffuse involvement of native organs and only focal involvement of graft, it was determined to be a non-donor derived myeloid sarcoma, a rare and aggressive extramedullary form of acute myeloid leukemia.Summary Fulminant liver failure with diffuse lymphadenopathy may be a presentation for myeloid sarcoma after HT. Further research is needed to understand the unique risks that HT contributes to the development and management of myeloid malignancies."

Acute Myelogenous Leukemia • Cardiomyopathy • Hematological Malignancies • Hepatology • Infectious Disease • Leukemia • Liver Failure • Lymphoma • Multiple Myeloma • Non-Hodgkin’s Lymphoma • Plasmacytoma • Sarcoma • Solid Tumor • Transplantation

Use of Belatacept in Recipients of Lung Transplantation with Refractory Cytopenias: A Case Series (ISHLT 2026) - "We present a case series of 3 patients with refractory cytopenias who improved with use of Belatacept as a part of maintenance immunosuppression.Case Report Patient #1 is a 58-year-old male who underwent bilateral orthotopic lung transplant (BOLT) for ILD who developed severe leukopenia while on combination of tacrolimus, mycophenolate and prednisone. His mycophenolate was replaced with sirolimus with no improvement. He was switched to cyclosporine in combination with belatacept with significant improvement of his leukopenia...While belatacept is often used for its ability to minimize nephrotoxicity from CNI toxicity, it has not been explored in patients for management of cytopenias. It could be a potential agent that can be considered for patients with refractory cytopenias as illustrated in our case series."

Clinical • Hematological Disorders • Immunology • Infectious Disease • Leukopenia • Pulmonary Disease • Respiratory Diseases • Solid Organ Transplantation • Transplantation

Asymptomatic Bilateral Pulmonary Nodules After Lung Transplantation: A Rare Diagnosis (ISHLT 2026) - "AMR was noted 1.5 months after LTX and successfully treated with our institutional multimodal AMR protocol of plasmapheresis, Carfilzomib, and ATG followed by monthly IVIG and Tocilizumab...For treatment, his immunosuppression was modified from Belatacept to mTOR based CNI sparing regimen with combined everolimus and low dose tacrolimus, monthly IVIG, and prednisone. As of day 446 post-transplant, surveillance follow-up CT scans demonstrate stable pulmonary nodules, with no evidence of disease progression on PET imaging or signs of allograft dysfunction.Summary KSHV causes a spectrum of disease following SOT, from malignant to non-malignant conditions, all of which are associated with poor prognosis. Consequently, early diagnosis—critical for successful management—relies on maintaining high index of suspicion and ensuring KSHV-related disease is included in the differential diagnosis."

Alpha-1 Antitrypsin Deficiency • Antibody-mediated Rejection • Chronic Obstructive Pulmonary Disease • Epstein-Barr Virus Infections • Genetic Disorders • Hepatology • Human Immunodeficiency Virus • Immunology • Infectious Disease • Kaposi Sarcoma • Nephrology • Pulmonary Disease • Respiratory Diseases • Sarcoma • Solid Organ Transplantation • Solid Tumor • Transplantation

Acute Myeloid Leukemia After Heart Transplantation in an Individual with Essential Thrombocytosis (ISHLT 2026) - "He was diagnosed with ET 10 years prior to HT and was maintained on hydroxyurea as cytoreductive therapy...Post-HT course was complicated by worsening renal function for which he was initiated on belatacept infusions while also being maintained on mycophenolate mofetil (MMF), tacrolimus with a lower trough goal and low dose prednisone...Given his new AML diagnosis, immunocompromised status, and no improvement of pneumonia with antibiotics, the patient was transitioned to comfort driven care and died.Summary This case identifies the complex interactions between immunosuppression and malignancy, and the potential role of his pre-existing ET. Further, this patient's course emphasizes the challenges and complications when managing AML in HT patients which may include neurological decline and infection."

Clinical • Acute Myelogenous Leukemia • Back Pain • Cardiomyopathy • Coronary Artery Disease • Essential Thrombocythemia • Febrile Neutropenia • Hematological Disorders • Hematological Malignancies • Hypertension • Infectious Disease • Leukemia • Musculoskeletal Pain • Myelofibrosis • Nephrology • Pneumonia • Renal Disease • Respiratory Diseases • Thrombocytosis • Transplantation

Addressing Rejection in Non-Adherent Heart Transplant Patients: Current and Emerging Options (ISHLT 2026) - "Tailored strategies are key to improve outcomes. Belatacept contributed to clinical stability, and enhanced therapeutic adherence in this patient."

Clinical • Acute Kidney Injury • Cardiovascular • Epilepsy • Infectious Disease • Nephrology • Pneumonia • Respiratory Diseases • Septic Shock • Transplant Rejection • Transplantation

Belatacept in Solid Organ Transplantation: Current Kidney Applications, Future Perspectives in Other Organs, and Clinical Implications. (PubMed, Pharmaceuticals (Basel)) - "While currently approved only for kidney transplantation, ongoing studies in thoracic and hepatic grafts may expand its therapeutic role. Personalized patient selection, combination regimens mitigating rejection risk, and real-world cost-effectiveness analyses will define its place in future precision immunosuppression strategies."

Journal • Review • Epstein-Barr Virus Infections • Solid Organ Transplantation • Transplant Rejection • Transplantation • CD80

SYMPOSIUM 20. The Antibody Strikes Back: Cases of Subclinical to Refractory AMR in Heart Transplantation (ISHLT 2026) - "Emerging strategies such as HALT (hepatic antibody absorption), next-generation biomarkers (donor-derived cfDNA, tissue GEP), and novel therapies (daratumumab, tocilizumab, proteasome inhibitors, belatacept, and ECP) will be discussed. Audience engagement will be emphasized through live voting on management decisions, fostering dialogue on controversies and best practices across the spectrum of AMR care."

Clinical • Antibody-mediated Rejection • Transplantation

Immunogenicity of the bivalent pre-F respiratory syncytial virus (RSV) vaccine in kidney transplant recipients with and without belatacept as maintenance immunosuppressive treatment (RSVVW 2026) - "In this pilot cohort of older KTR, most receiving belatacept, approximately half achieved a ≥4-fold antibody rise after a single RSV vaccine dose, with maintained responses in one-third at 6 months and no detectable negative impact of belatacept. Larger studies are required to confirm these findings, and additional vaccine doses may be needed to optimize protection in a subset of this high-risk group."

Clinical • Infectious Disease • Influenza • Novel Coronavirus Disease • Respiratory Diseases • Respiratory Syncytial Virus Infections • Transplantation

Systematic review and meta-analysis of belatacept versus calcineurin inhibitors on risk of post-transplant diabetes mellitus in kidney transplant recipients. (PubMed, Front Immunol) - "Notably, both LI and MI dosing regimens showed protective effects, suggesting that even low-intensity belatacept therapy could serve as a viable alternative to CNIs, particularly for patients requiring reduced immunosuppressive toxicity. https://inplasy.com/, identifier INPLASY202540041."

Journal • Retrospective data • Review • Diabetes • Metabolic Disorders • Transplantation

Management of Immunosuppression-Induced Thrombotic Microangiopathy in Heart Transplant Recipient: A Case Report (ISHLT 2026) - "Everolimus was discontinued, and supportive care with transfusions, filgrastim, and intravenous immunoglobulin was initiated. The patient was discharged on MMF, low-dose methylprednisolone, and maintenance belatacept. At three-month follow-up, he remained asymptomatic with preserved graft function and no TMA recurrence.Summary This case illustrates successful management of sequential tacrolimus- and everolimus-induced TMA with belatacept-based immunosuppression, maintaining graft stability and addressing a key unmet need in post-transplant care."

Case report • Clinical • Hematological Disorders • Leukopenia • Thrombocytopenia • Transplantation • HP