Table 2.
Effect sizes related to the different subgroup analyses.
| Subgroup analyses for allograft survival | Effect size | 95% CI | I2, p-value | |
|---|---|---|---|---|
| Effect of complement-activating anti-HLA DSAs in studies with high or low methodological quality | High-methodological quality studies NOS ≥6 | 2.79 | 2.33-3.35 | 45.7%, p<0.001 |
| Low-methodological quality studies NOS ≤ 5 | 2.46 | 1.28-4.70 | 60.5%, p<0.001 | |
| Effect of complement-activating anti-HLA DSAs in studies with different comparators used | Studies comparing index group and patients with non-complement-activating anti-HLA DSAs | 2.56 | 1.99-3.30 | 54.2%, p< 0.001 |
| Studies comparing index group and patients with non-complement-activating anti-HLA DSAs and without anti-HLA DSAs | 3.58 | 2.70-4.74 | 4.1%, p<0.001 | |
| Effect of complement-activating anti-HLA DSAs according to the type of solid organ transplant | Kidney transplantation studies only | 2.77 | 2.25-3.41 | 49.2%, p< 0.001 |
| Heart, lung, and liver transplantation studies | 2.74 | 2.03-3.69 | 29.2%, p<0.001 | |
| Effect of complement-activating anti-HLA DSAs according to the timing of antibody detection | Pre-existing DSAs | 2.56 | 1.99-3.30 | 56.2%, p< 0.001 |
| Pre-existing and de novo DSAs | 2.59 | 2.05-3.26 | 34.3%, p<0.001 | |
| De novo DSAs | 3.53 | 2.63-4.74 | 26.0%, p<0.001 | |
| Effect of complement-activating anti-HLA DSAs according to the type of test used for detecting complement-activating antibodies | C1q | 2.72 | 2.19-3.38 | 35.8%, p= 0.001 |
| C4d | 3.81 | 2.02-7.2 | 33.0%, p= 0.001 | |
| C3d | 2.50 | 1.48-4.25 | 73.1%, p< 0.001 | |
| IgG3 | 3.17 | 2.37-4.24 | 0.00%, p<0.001 | |
| Effect of complement-activating anti-HLA DSAs according to the MFI thresholds for complement-activating anti-HLA DSA positivity | 300 | 2.74 | 1.91-3.93 | 36.7%, p<0.001 |
| 500 | 2.29 | 2.29-3.82 | 47.8%, p<0.001 | |
| 1000 | 2.37 | 1.7-3.29 | 49.1%, p<0.001 | |
Effect sizes refer to HR for graft survival and OR for rejection appearance. The Index group refers to patients with complement-activating anti-HLA DSAs.
DSA, donor-specific antibody; C1q, complement component 1q; CI, confidence interval; HR, hazard ratio; HLA, human leukocyte antigen; I2, heterogeneity; IgG3, immunoglobulin G3; MFI, MFI, Mean fluorescent intensity, NOS, Newcastle-Ottawa scale; OR, odds ratio.