Table 6 |.
Comparison of Cedars-Sinai and Necker cohorts
| Variable | Cedars-Sinai | Necker |
|---|---|---|
|
| ||
| Number of cases | 147 | 61 |
| Age at the time of biopsy, yr | 42.4 ± 16.9 | 51.4 ± 14.8 |
| Months, transplant to biopsy | 30.0 (6.0–72.0) | 3.0 (1.0–6.0) |
| Graft loss (yes/no) | 61/86 (41/59) | 16/45 (26/74) |
| HLA DSA class | ||
| I only | 27 (18) | 14 (23) |
| II only | 84 (57) | 34 (56) |
| I and II | 36 (24) | 13 (21) |
| Number of DSAs | ||
| 1 | 72 (49) | 37 (61) |
| >1 | 75 (51) | 24 (39) |
| DSA sum strength (sum of MFIs) | ||
| <5000 | 38 (26) | 40 (66) |
| 5000–10,000 | 50 (34) | 10 (16) |
| >10,000 | 59 (40) | 11 (18) |
| DSA type | ||
| De novo | 91 (62) | 15 (25) |
| Persistent/rebound | 56 (38) | 46 (75) |
| AMR type | ||
| Active | 78 (53) | 58 (95) |
| Chronic active | 69 (47) | 3 (5) |
| TCMR (acute or chronic active) | ||
| None/borderline | 102 (69) | 48 (79) |
| ≥1A | 45 (31)a | 13 (21)a |
| C4d in peritubular capillaries | ||
| Positive/negative | 98/49 | 35/23b |
| % positive | 67 | 60 |
| Thrombotic microangiopathy | ||
| Present/absent | 9/138 | 3/58 |
| % present | 6 | 5 |
| Biopsy indication | ||
| For cause | 147 (100) | 43 (70) |
| Protocol | 0 (0) | 18 (30) |
| Postbiopsy treatments | ||
| IVIG | 145 (99) | 48 (79) |
| Rituximab | 117 (80) | 35 (57) |
| Corticosteroids | 69 (47) | 57 (93) |
| PP/PE | 36 (24) | 50 (82) |
| Eculizumab | 6 (4) | 0 (0) |
| Tocilizumab | 11 (7) | 0 (0) |
| Othersc | 24 (16) | 2 (3) |
| AI | 5 (4–7) | 5 (4–6) |
| CI | 3 (1–7) | 2 (0–4) |
| (AI + CI) | 9 (6–13) | 7 (5–10) |
AI, activity index; AMR, antibody-mediated rejection; CI, chronicity index; DSA, donor-specific antibody; HLA, human leukocyte antigen; IVIG, i.v. immunoglobulin; MFI, mean fluorescence intensity; PE, plasma exchange; PP, plasmapheresis; TCMR,T cell-mediated rejection.
Five biopsies from each cohort listed as showing TCMR ≥ Banff grade 1A had isolated intimal arteritis, defined as Banff v (arteritis) score of 1 or 2 with i (interstitial inflammation score) = 0, t (tubulitis score) = 0, or both. C4d was determined by immunofluorescence on frozen sections with Banff C4d scores assigned accordingly as negative (C4d 0–1) or positive (C4d 2–3).
C4d staining was not performed for 3 of the Necker cases.
Other treatments for AMR included bortezomib, alemtuzumab, and obinutuzumab.
Data are expressed as mean ± SD, median (interquartile range), or n (%).