TABLE 1.
Cohort demographics and clinical features
| Patients with ABMR (N = 26) | Patients with TCMR (N = 62) | Patients with Nonrejection (N = 336) | All patientsa (N = 424) | |
|---|---|---|---|---|
| Age (median [IQR]), y | 46 (33.5–62.3) | 50 (33.5–59.4) | 53 (42.3–63.0) | 52 (41–62.3) |
| BMI (median [IQR]) (kg/m2) | 27 (22.9–31.2) | 30 (25.2–33.4) | 28 (24.7–33.1) | 28 (24.7–33.1) |
| Sex | ||||
| Male | 14 (53.8%) | 35 (56.5%) | 205 (61.0%) | 254 (59.9%) |
| Female | 12 (46.2%) | 27 (43.5%) | 131 (39.0%) | 170 (40.1%) |
| Race | ||||
| African American | 8 (30.8%) | 22 (35.6%) | 84 (25.0%) | 114 (26.9%) |
| White | 12 (46.2%) | 27 (43.5%) | 182 (54.2%) | 221 (52.1%) |
| Asian | 2 (7.7%) | 3 (4.8%) | 15 (4.5%) | 20 (4.7%) |
| Other | 1 (3.8%) | 5 (8.1%) | 30 (8.9%) | 36 (8.5%) |
| Unknown | 1 (3.8%) | 2 (3.2%) | 9 (2.7%) | 12 (2.8%) |
| Not entered | 2 (7.7%) | 3 (4.8%) | 16 (4.7%) | 21 (5.0%) |
| Ethnicity | ||||
| Hispanic | 7 (26.9%) | 11 (17.7%) | 63 (18.7%) | 81 (19.1%) |
| Non-Hispanic | 18 (69.2%) | 50 (80.7%) | 268 (79.8%) | 336 (79.2%) |
| Not entered | 1 (3.8%) | 1 (1.6%) | 5 (1.5%) | 7 (1.7%) |
| Days from transplant to biopsy (median [range]) | 294 (186–425) | 246 (129–407) | 224(149–376) | 238 (148–378) |
| No. dd-cfDNA tests before biopsy (per patient) (mean [range]) | 3 (2–4)b | 2 (1–3) | 2 (2–3) | 2 (2–3) |
| Biopsy type | ||||
| For cause | 22 (84.6%)c | 578(93.5%)d | 175 (52.1%) | 255 (60.1%) |
| For protocol | 4 (15.4%)c | 4 (6.5%)d | 161 (47.9%) | 169 (39.9%) |
| Donor type | ||||
| Living | 3 (11.5%) | 13 (21.0%) | 84 (25.0%) | 100 (23.6%) |
| Related | 0 (0.0%) | 6 (9.7%) | 23 (6.8%) | 29 (6.8%) |
| Unrelated | 26 (100%) | 53 (85.5%) | 290 (86.4%) | 369 (87.1%) |
| Unknown | 0 (0%) | 3 (4.8%) | 23 (6.8%) | 26 (6.1%) |
| Deceased | 23 (88.5%) | 49 (79.0%) | 252 (75.0%) | 324 (76.4%) |
| Donation after brain death | 21 (80.8%)c | 30 (48.4%) | 148 (44.0%) | 199 (46.9%) |
| Donation after circulatory death | 2 (7.7%)c | 18 (29.0%) | 101 (30.1%) | 121 (28.5%) |
| Unknown | 3 (11.5%)c | 14 (22.6%) | 87 (25.9%) | 104 (24.5%) |
| KDPI (median [IQR]) | 39 (17.5–49.5)a | 44 (24.5–68.7) | 53 (36.0–72.0) | 51 (30.8–71.0) |
| Sensitization status | ||||
| cPRA > 80 | 8 (30.8%)d | 8 (12.9%)d | 34 (10.1%) | 50 (11.8%) |
| cPRA ≤ 80 | 11 (42.3%)d | 25 (40.3%)d | 249 (74.1%) | 285 (67.2%) |
| Unavailable | 7 (26.9%)d | 29 (46.8%)d | 53 (15.8%) | 89 (21.0%) |
| DSA status | ||||
| DSA-positive | 15 (57.7%)d | 11 (17.7%) | 55 (16.4%) | 81 (19.1%) |
| DSA-negative | 5 (19.2%)d | 22 (35.5%) | 147 (43.7%) | 174 (41.0%) |
| Not donee | 6 (23.1%)d | 29 (46.8%) | 134 (39.9%) | 169 (39.9%) |
| Transplant indication | ||||
| Type 2 diabetes | 5 (19.2%) | 7 (11.2%) | 84 (25%) | 96 (22.6%) |
| Hypertension | 8 (30.7%) | 18 (29%) | 54 (16.0%) | 80 (18.8 %) |
| Autoimmune diseases | 2 (7.7%) | 5 (8.0%) | 35 (10.4%) | 42 (9.9%.) |
| Polycystic kidney Disease | 1 (3.8%) | 5 (8.0%) | 32 (9.5%) | 38 (8.9%) |
| Glomerulonephritis | 4 (15.4%) | 5 (8.0%) | 21 (6.2%) | 30 (7.1%) |
| FSGS | 0 (0%) | 5 (8.0%) | 22 (6.5%) | 27 (6.6%) |
| IgA nephropathy | 1 (3.8%) | 6 (9.7%) | 21 (6.2%) | 28 (6.6%) |
| Others | 5 (19.2%) | 11 (17.7%) | 67 (19.9%) | 83 (19.6%) |
| Retransplant | ||||
| Yes | 3 (11.5%) | 3 (4.8%) | 27 (8.0%) | 33 (7.8%) |
| No | 23 (88.5%) | 59 (95.2%) | 304 (90.5%) | 386 (91.0%) |
| Unknown | 0 (0.0%) | 0 (0.0%) | 5 (1.5%) | 5 (1.2%) |
| Graft status | ||||
| Functioning | 25 (96.2%) | 56 (90.3%) | 323 (96.1%) | 404 (95.3%) |
| Loss | 1 (3.8%) | 6 (9.7%) | 13 (3.9%) | 20 (4.7%) |
| Recipient status | ||||
| Alive | 24 (92.3%) | 61 (98.4%) | 320 (95.2%) | 405 (95.5%) |
| Dead | 2 (7.7%) | 1 (1.6%) | 16 (4.8%) | 19 (4.5%) |
a
Wilcoxon rank-sum test or Fisher exact test with FDR correction for multiple testing comparing to No Rejection.
b
P < 0.05.
c
P < 0.01.
d
P < 0.001.
e
No DSA test was done within 90 d of biopsy.
ABMR, antibody-mediated rejection; BMI, body mass index; cPRA, calculated panel-reactive antibody; DSA, donor-specific antibody; FSGS, focal segmental glomerulosclerosis; KDPI, kidney donor profile index; TCMR, T cell–mediated rejection.