Early Conversion From CNI to Belatacept in Renal Transplant Recipients With Delayed and Slow Graft Function

Inclusion Criteria

• •Before any study procedures are performed, subjects will have the details of the study described to them, and they will be given a written informed consent document to read. Then, if subjects consent to participate in the study, they will indicate that consent by signing and dating the informed consent document in the presence of study personnel.
• •All patients (\> 18 years) who have received a deceased donor transplant and are at risk for SGF/DGF will be studied
• •All gender and ethnicities will be considered in this study
• •At risk for SGF/DGF is defined as:
• •* ECD (Extended Criteria Donor) donor kidney recipients
• •* ECD is defined as a donor over the age of 60 or age 50 to 60 with 2 of the following risk factors:
• •Terminal creatinine \> 1.5 mg/dL
• •History of Hypertension
• •Death due to cerebrovascular accident
• •* Donations after cardiac death (DCD) kidney recipients
• •* Donor organs with an actual cold ischemia time (CIT) \> 19 hours
• •* Recipients of donor organs with a terminal creatinine \> 1.5 mg/dL
• •Only patients who receive Thymoglobulin induction and CNI maintenance at time of randomization will be considered for the study
• •Men and women, 18 to 70 years of age
• •Reproductive status: Definition of Women of Child-Bearing Potential (WOCBP). WOCBP comprises women who have experienced menarche and who have not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or who are not post-menopausal.
• •Post-menopause is defined as:
• •Women who have had amenorrhea for \>= 12 consecutive months (without another cause) and who have a documented serum follicle-stimulating hormone (FSH)level \> 35 mIU/mL
• •Women who have irregular menstrual periods and a documented serum FSH level \> 35 mIU/mL
• •Women who are taking hormone replacement therapy
• •The following are WOCBP:
• •Women using the following methods to prevent pregnancy: oral contraceptives, other hormonal contraceptives (vaginal products, skin patches, or implanted or injectable products), or mechanical products such as intrauterine devices or barrier methods (diaphragm, condoms, spermicides).
• •Women who are practicing abstinence
• •Women who have a partner who is sterile (due to vasectomy)
• •WOCBP must be using an acceptable method of contraception to avoid pregnancy throughout the study and for up to 8 weeks after the last dose of study drug in such a manner that the risk of pregnancy is minimized
• •WOCBP must have a negative serum or urine pregnancy test result (minimum sensitivity 25 IU/L or equivalent units of HCG) within 24 hours before the first dose of study drug.
• •Women must not be breast-feeding
• •Sexually active fertile men must use effective birth control if their partners are WOCBP