Table 4.
Associations of crossmatch modality with first-year acute rejection risk1 within the full sample of transplants performed in 1999−2005 and within clinical subgroups
| T&B FC2 | T AHG2 | |||
|---|---|---|---|---|
| Sample | aOR (95% CI) | P-Value | aOR (95% CI) | P-Value |
| Full sample | 0.85 (0.80 − 0.89) | <.0001 | 0.96 (0.91 − 1.02) | 0.2239 |
| Subgroup | ||||
| Recipient Race | ||||
| Caucasian | 0.81 (0.75 − 0.87) | <.0001 | 1.01 (0.94 − 1.09) | 0.7873 |
| African-American | 1.00 (0.90 − 1.11) | 0.9753 | 0.95 (0.84 − 1.07) | 0.4047 |
| Hispanic or other | 0.73 (0.64 − 0.83) | <.0001 | 0.77 (0.66 − 0.90) | 0.0013 |
| Recipient Age | ||||
| 0−18 | 1.12 (0.91 − 1.39) | 0.2837 | 1.21 (0.95 − 1.56) | 0.1274 |
| 19−45 | 0.88 (0.81 − 0.95) | 0.0019 | 0.97 (0.88 − 1.06) | 0.4637 |
| 46−60 | 0.79 (0.72 − 0.86) | <.0001 | 0.94 (0.85 − 1.04) | 0.2192 |
| >60 | 0.80 (0.70 − 0.92) | 0.002 | 0.90 (0.78 − 1.05) | 0.1824 |
| Peak PRA (%) | ||||
| 0−10 | 0.84 (0.79 − 0.90) | <.0001 | 0.90 (0.84 − 0.97) | 0.0038 |
| 11−50 | 0.96 (0.82 − 1.12) | 0.5582 | 1.31 (1.10 − 1.55) | 0.0023 |
| >50 | 0.80 (0.68 − 0.93) | 0.0043 | 1.23 (1.02 − 1.50) | 0.0341 |
| Transplant Number | ||||
| First transplant | 0.87 (0.82 − 0.92) | <.0001 | 0.96 (0.90 − 1.02) | 0.1759 |
| Re-transplant | 0.73 (0.62 − 0.86) | 0.0001 | 1.06 (0.89 − 1.27) | 0.5125 |
| HLA Matching | ||||
| 0 ABDR MM | 0.79 (0.65 − 0.96) | 0.0172 | 0.73 (0.58 − 0.92) | 0.0082 |
| 0 DR MM | 0.83 (0.73 − 0.94) | 0.0037 | 0.90 (0.78 − 1.04) | 0.1689 |
| DR MM | 0.86 (0.81 − 0.91) | <.0001 | 1.01 (0.94 − 1.08) | 0.8871 |
| Donor Type | ||||
| Living | 0.93 (0.85 − 1.01) | 0.0748 | 1.05 (0.95 − 1.16) | 0.3783 |
| Deceased3 | 0.80 (0.74 − 0.85) | <.0001 | 0.92 (0.85 − 0.99) | 0.0301 |
| Donor Donor Quality | ||||
| SCD | 0.81 (0.75 − 0.88) | <.0001 | 0.98 (0.90 − 1.06) | 0.549 |
| ECD | 0.76 (0.65 − 0.90) | 0.0011 | 0.79 (0.67 − 0.94) | 0.0075 |
| DCD | 0.75 (0.49 − 1.13) | 0.1673 | 0.56 (0.36 − 0.87) | 0.0089 |
Rejection within the first year after transplant was defined by individual transplant programs, as reported to the OPTN
The study sample was limited to transplants with negative crossmatch results. T & B FC and T AHG-only crossmatch were compared to the reference group, T AHG &B crossmatch. An aOR <1.0 indicates that risk of rejection in association with the modeled crossmatch test was lower compared to T AHG &B in a particular sample. An aOR >1.0 indicates that risk of rejection in association with the modeled crossmatch test was higher compared to T AHG &B in a particular sample. P-values reflect the significance of difference in rejection risk associated with the indicated crossmatch test compared to T AHG &B within a specified sample.
Deceased donor is a composite of SCD, ECD and DCD
aOR: adjusted odds ratio