Table 1.
Comparisons between patients who had or had not undergone an allograft nephrectomy
| Parameters | Patients with an Allograft Nephrectomy (Group I; n=48) | Patients with a Clinically Indicated Allograft Nephrectomy (n=31) | Patients with a Systematic Allograft Nephrectomy (n=17) | Patients without an Allograft Nephrectomy: (Group II; n=21) |
|---|---|---|---|---|
| Recipient age at transplantation (years) | 38.6±16 | 40.3±17 | 35.6±14 | 34.6±11 |
| Recipient sex: male (%) | 35 (72.9) | 22 (71) | 13 (76) | 19 (90) |
| Donor age (years) | 39.6±18.7 | 43.4±18 | 36±17 | 40.3±15 |
| Type of donor: deceased (%) | 47 (98) | 30 (97) | 17 (100) | 21 (100) |
| Number of previous transplantations | 1.27±0.57 | 1.22±0.42 | 1.35±0.79 | 1.38±0.59 |
| Nephrectomy for previous kidney transplantation (%) | 9/11 (81.8) | 7/7 (100) | 2/4 (50) | 4/7 (57.1) |
| Number of HLA A/B/DR/DQ mismatches | 3.98±1.83 | 4.03±2.02 | 3.88±1.45 | 3.5±1.8 |
| Number of HLA A/B mismatches | 2.45±1.05 | 2.38±1.11 | 2.59±0.94 | 2.1±1.27 |
| Number of HLA DR/DQ mismatches | 1.48±1.24 | 1.64±1.35 | 1.17±0.95 | 1.57±0.87 |
| Patients with DSAs at transplantation | 0 | 0 | 0 | 0 |
| Induction therapy: yes (%) | 39 (81.3) | 25 (81) | 14 (82) | 18 (85.7) |
| Polyclonal ab/anti–IL-2R induction therapy | 24/15a | 15/10 | 9/5 | 17/1a |
| Rituximab induction therapy: yes (%) | 1 (2) | 1 (3) | 0 | 0 |
| Initial immunosuppression after transplantation: CNIs (%) | 47 (97.8) | 30 (97) | 17 (100) | 20 (95) |
| Cyclosporine A/tacrolimus (%) | 31 (66)/16 (34) | 22 (70)/8 (30) | 9 (53)/8 (47) | 19 (89.4)/2 (10.6) |
| mTOR inhibitors (%) | 4 (8.9) | 3 (9.5) | 1 (6) | 1 (5) |
| MPA (%) | 32 (66.7) | 21 (67.8) | 11 (60) | 17 (83) |
| steroids (%) | 48 (100) | 31 (100) | 17 (100) | 21 (100) |
| Immunosuppression at graft loss | 38 (79.1) | |||
| CNIs (%) | 10 (26.3)/28 (73.7) | 25 (80.6) | 13 (76.5) | 16 (75) |
| cyclosporine A/tacrolimus (%) | 4 (9) | 6 (24)/19 (76) | 4 (31)/9 (69) | 9 (53)/7 (47) |
| mTOR inhibitors (%) | 36 (75) | 1 (3) | 3 (17) | 2 (9) |
| MPA (%) | 43 (89.6) | 23 (77.4) | 13 (82) | 17 (81) |
| steroids (%) | 30 (93.5) | 15 (88) | 21 (100) | |
| Rejection episodes during the transplant period (%) | 27 (56) | 18 (58) | 9 (53) | 12 (55) |
| Number of rejection episodes per patient | 1 (0–4) | 1 (0–4) | 1 (0–2) | 1 (0–2) |
| Steroid-sensitive rejection episodes (%) | 16 (33.5) | 13 (42) | 3 (18) | 10 (48) |
| Number of steroid-sensitive episodes per patient | 0 (0–2) | 0 (0–2) | 0 (0–1) | 0 (0–2) |
| Steroid-resistant rejection episodes (%) | 15 (31) | 9 (29) | 6 (41) | 4 (20) |
| Humoral rejection episodes (%) | 6 (12.5) | 4 (12.9) | 2 (11.7) | 3 (14.2) |
| Rituximab use during transplant period: yes (%) | 11 (23) | 8 (26) | 3 (18) | 6 (28.5) |
| Number of Rituximab injections/patientb | 2 (2–5) | 3 (2–5) | 2 | 2 |
| Time between last Rituximab and graft failure (days) | 410 (20–1740) | 330 (120–870) | 596 (20–1740) | 405 (60–2160) |
| Time between last Rituximab therapy and nephrectomy (days) | 581 (95–1800) | 498 (180–1050) | 800 (31–1800) | — |
| Plasma exchange during transplant period: yes (%) | 7 (14.6) | 6 (19) | 1 (6) | 6 (28.5) |
| Number of plasma exchanges during the transplant period | 9 (5–14)a | 9 (5–14) | 12 | 6c |
| Time between transplantation and graft failure (days) | 1768 (81–7785) | 1340 (81–7351) | 3330 (80–7785) | 4099 (493–10013) |
| Time between graft failure and graft nephrectomy (days) | 150 (100–3390) | 169 (100–3390) | 143 (110–1119) | — |
| Time between graft failure and last follow-up (days) | 680 (111–3939) | 696 (111–3939) | 673 (137–1436) | 836 (33–3018) |
| Number of patients with DSAs at graft failure (%) | 6 (12.5) | 4 (12.9) | 2 (11.7) | 3 (14.2) |
| Number of patients with DSAs at graft nephrectomy (%) | 17 (35.4) | 10 (32.2) | 7 (41.2) | — |
| Number of patients with DSAs at last follow-up (%) | 39 (81)a | 25 (80.6) | 14 (82.3) | 11 (52.4)c |
| Time between nephrectomy and de novo DSA (days) | 5 (5–1097) | 5 (5–1097) | 5 (5–270) | — |
a
HLA, human leukocyte antigen; DSA, donor-specific antibodies; CNIs, calcineurin inhibitors; mTOR, mammalian target of rapamycin; MPA, mycophenolic acid.
b
The Rituximab dose of each injection was 375 mg/m2.
c
P<0.05.