The success of belatacept in late-stage clinical trials inaugurates the arrival of a new class of
immunosuppressants based on costimulatory blockade, an immunosuppression strategy
that disrupts essential signals required for alloreactive T-cell activation. Despite having
improved renal function, kidney transplant recipients treated with belatacept experienced
increased rates of acute rejection. This finding has renewed focus on costimulatory blockade-
resistant rejection and specifically the role of alloreactive memory T cells in mediating this …