Table 4.
Risk factors for the development of antibody-mediated rejection
| Risk factors for ABMR# development | Unadjusted HR (95% CI) | p value | Adjusted HR (95% CI) | p value |
|---|---|---|---|---|
| Age at KTx, years | 1.06 (1.01–1.13) | 0.027 | 1.06 (1.00–1.13) | 0.048 |
| > 1 KTx (> 1 versus 1) | 2.39 (1.14–5.02) | 0.022 | 1.85 (0.85–4.04) | 0.122 |
| HLA-DR mismatch (0 versus 1 or 2) | 1.80 (1.13–2.90) | 0.014 | 1.85 (1.13–3.02) | 0.015 |
| CMV IgG negative recipient and negative donor | 0.39 (0.17–0.88) | 0.024 | 0.40 (0.18–0.90) | 0.027 |
| Preformed HLA-DSA | 2.37 (1.02–5.53) | 0.045 | 1.30 (0.54–3.14) | 0.563 |
| TCMR/borderline rejection | 1.14 (0.53–2.43) | 0.743 | ||
| BKPyV nephropathy | 0.99 (0.13–7.31) | 0.99 | ||
| de novo class I HLA-DSA only1,2 | 3.07 (0.73–13.0) | 0.127 | ||
| de novo class II HLA-DSA only1,2 | 3.38 (1.49–7.63) | 0.003 | 3.78 (1.62–8.82) | 0.002 |
| de novo class I and II HLA-DSA1,2 | 4.42 (1.68–11.6) | 0.003 | 5.00 (1.75–14.2) | 0.001 |
ABMR antibody-mediated rejection, CI confidence interval, DSA donor-specific antibodies, HLA human leukocyte antigen, HR hazard ratio, KTx kidney transplantation, TCMR T-cell mediated rejection
1De novo HLA-DSA and histopathologic diagnoses were regarded as time-dependent co-variables
2Data were reported by the respective transplant centers according to the center-specific cut-off for HLA-DSA positivity
#ABMR includes acute ABMR, chronic active ABMR, and mixed rejections