Table 1.
Demographic and transplant characteristics of KTRs, by day 0 anti-RBD level.
| Total (N = 81) | anti-RBDNEG (N = 39) | anti-RBDLO (N = 42) | P | |
|---|---|---|---|---|
| Demographics | ||||
| Age (y), median (IQR) | 66 (57, 73) | 65 (56, 73) | 66 (57, 74) | .99 |
| Female sex, no. (%) | 27 (33) | 17 (44) | 10 (24) | .10 |
| Race, no. (%) | .75 | |||
| White | 49 (60) | 22 (56) | 27 (64) | |
| Black/African American | 24 (30) | 12 (31) | 12 (29) | |
| Asian | 4 (5) | 2 (5) | 2 (5) | |
| Other | 4 (5) | 3 (8) | 1 (2) | |
| Hispanic/Latino ethnicity, no. (%) | 2 (2) | 2 (5) | 0 (0) | .23 |
| BMI (kg/m2), median (IQR) | 26.2 (23.4, 31.2) | 27.5 (23.2, 32.0) | 25.8 (23.4, 31.1) | .53 |
| Medical comorbidities | ||||
| Diabetes, no. (%) | 27 (33) | 13 (33) | 14 (33) | >.99 |
| HCV infection, no. (%) | 5 (6) | 1 (3) | 4 (10) | .36 |
| Lung disease, no. (%) | 25 (31) | 14 (36) | 11 (26) | .47 |
| Cardiovascular disease, no. (%) | 80 (99) | 38 (97) | 42 (100) | .48 |
| Autoimmune disease, no. (%) | 12 (15) | 7 (18) | 5 (12) | .54 |
| Transplant history and immunosuppression | ||||
| Years since transplant, median (IQR) | 5.4 (2.1, 10.5) | 5.0 (2.0, 9.2) | 5.7 (3.2, 10.9) | .23 |
| Indication for most recent kidney transplantation, no. (%) | ||||
| Diabetes | 13 (16) | 6 (15) | 7 (17) | >.99 |
| Hypertension | 28 (35) | 16 (41) | 12 (29) | .25 |
| FSGS | 6 (7) | 5 (13) | 1 (2) | .10 |
| Cystic kidney disease | 11 (14) | 3 (8) | 8 (19) | .20 |
| Living donor, no. (%) | 35 (43) | 14 (36) | 21 (50) | .26 |
| DSA positive at baseline, no. (%) (n = 79) | 14 (17) | 7 (18) | 7 (18)a | >.99 |
| Baseline Immunosuppressant, no. (%) | ||||
| Mycophenolate mofetil | 56 (69) | 27 (69) | 29 (69) | >.99 |
| Total daily dose (mg), median (IQR) | 1000 (500, 1000) | 1000 (500, 1000) | 1000 (500, 1000) | .95 |
| Mycophenolic acid | 8 (10) | 5 (13) | 3 (7) | .47 |
| Total daily dose (mg), median (IQR) | 720 (540, 900) | 810 (720, 1440) | 540 (270, 810) | .16 |
| High-dose mycophenolate | 14 (17) | 9 (23) | 5 (12) | .37 |
| Prednisone | 75 (93) | 36 (92) | 39 (93) | >.99 |
| Total daily dose (mg), median (IQR) | 5 (5, 5) | 5 (5, 5) | 5 (5, 5) | .94 |
| Tacrolimus | 75 (93) | 38 (97) | 37 (88) | .20 |
| Cyclosporine | 4 (5) | 1 (3) | 3 (7) | .62 |
| Triple IS, no. (%)b | 58 (72) | 29 (74) | 29 (69) | .63 |
| COVID-19 and vaccination history | ||||
| Prior SARS-CoV-2 infectionc, no. (%) | 4 (5) | 3 (8) | 1 (2) | .35 |
| Days between second and third dose, median (IQR) | 167 (149, 177) | 159 (141, 174) | 169.5 (152, 183) | .10 |
| Vaccine manufacturer, no. (%) | .46 | |||
| Pfizer-BioNTech (BNT162b2) | 59 (73) | 30 (77) | 29 (69) | |
| Moderna (mRNA-1273) | 22 (27) | 9 (23) | 13 (31) | |
| Laboratory results | ||||
| Creatinine (mg/dL), median (IQR) | ||||
| Day 0 (Baseline) | 1.2 (1, 1.5) | 1.2 (1, 1.5) | 1.2 (1.1, 1.5) | .59 |
| Day 30 | 1.2 (1, 1.5) | 1.3 (1, 1.5) | 1.2 (1.1, 1.5) | .78 |
| Estimated GFR (ml/min/1.73m2), median (IQR) | ||||
| Day 0 | 58 (46, 73) | 57 (49, 72) | 59.5 (46, 74) | .91 |
| Day 30 | 59 (46, 72) | 55 (46, 72) | 60.5 (45, 73) | .82 |
| Baseline ALC (K/cu mm), median (IQR) | 1.01 (0.69, 1.47) | 1.01 (0.66, 1.55) | 1.00 (0.7, 1.37) | .82 |
| Baseline Total IgG (mg/dL), median (IQR) | 859 (737, 1057) | 863 (755, 1008) | 834 (732, 1086) | .89 |
| Baseline CD4+ T cell count, median (IQR)d | 172 (114, 225) | 183 (111, 228) | 171 (114, 220) | .56 |
| Recipient CMV IgG positive, no. (%) (n=72) | 38 (53) | 18 (53) | 20 (51) | >.99 |
ALC, absolute lymphocyte count; BMI, body mass index; CMV, cytomegalovirus; DSA, donor-specific antibody; FSGS, focal segmental glomerulosclerosis; GFR, glomerular filtration rate; IgG, immunoglobulin G; HCV, hepatitis C virus; IQR, interquartile range; IS, immunosuppressant. Continuous outcomes compared by Wilcoxon rank-sum testing and categorical variables were compared by Fisher exact testing.
Donor HLA typing unavailable for n = 1 participant and day 0 recipient DSA screening missing for n = 1 participant.
Any combination of 3 immunosuppressants at day 0 (calcineurin inhibitor, antimetabolite, corticosteroid).
By positive prior molecular testing or reactive anti-nucleocapsid antibody at enrollment.
T cell subtyping performed on n = 34 KTRs (16 anti-RBDNEG, 18anti-RBDLO)