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BELATACEPT INJ,LYPHL

Clinical Criteria Summary

General Criteria Structure

  • All mandatory inclusion criteria must be met.
  • At least one additional inclusion criterion must also be met.

Transplant Recipient Status & Clinical Indications

  • Veteran is a kidney transplant recipient
  • Chronic allograft nephropathy or calcineurin inhibitor (CNI) toxicity on biopsy
  • Unmanageable CNI intolerance (e.g., tremors, headache, thrombotic microangiopathy, post-transplant diabetes)
  • Preference for avoidance or minimization of long-term CNI exposure
  • Chronic antibody-mediated rejection or donor-specific antibody suppression

Provider & Care Coordination Requirements

  • Requesting provider must be a nephrologist or post-kidney transplant designee (e.g., locally designated expert)
  • Documentation must show concurrent communication with the transplant team

Infectious Disease Screening & Safety

  • Veteran must be Epstein-Barr seropositive
  • No active or untreated infections
  • Tuberculosis screening completed within the past year (e.g., QuantiFERON gold)

Special Populations & Pregnancy Considerations

  • For women of childbearing age: Confirm no alternative treatment exists and benefits outweigh risks due to limited/conflicting information regarding fetal harm risk.

Source Documents