Table 2.
Transplant-specific characteristics for patients included in the analysis
| Study, Year | Patients (n) | Desensitized | MFI Cutoff Positive DSA | Induction | Maintenance | Steroid-Free | No DSA Group Includes Pts with Other HLA Ab | Renal Function at Follow-up |
|---|---|---|---|---|---|---|---|---|
| Patel et al., 20078 | 20 DSA+ | No | NA | 20% none, 55% rATG, 15% CD25 monoclonal antibody, 10% alemtuzumab | 85% prednisone, 15% CSA, 85% FK | Some | ND | 1.3 |
| 40 DSA− | 1.1 | |||||||
| Gupta et al., 20086 | 16 DSA+ | No | NA | None | CSA, azathioprine, prednisone | No | Yes | 1.55 |
| 115 DSA− | 1.77 | |||||||
| Vlad et al., 200910 | 13 DSA+ | No | 1000±500 | rATG (6 mg/kg) | FK, MMF, steroids tapered on day 5 | Yes | ND | NA |
| 265 DSA− | ||||||||
| Couzi et al., 20115 | 11 DSA+ | No | >500 | rATG or daclizumab | MMF + CNI + steroids | No | ND | 1 yr eGFR, 59 |
| 34 DSA− | 1 yr eGFR, 66 | |||||||
| Willicombe et al., 201111 | 45 DSA+ | No | NA | Alemtuzumab | FK alone | Yes | ND | 3 yr Cr, 2.67 |
| 435 DSA− | 3 yr Cr, 1.41 | |||||||
| Verghese et al., 20109 | 10 DSA+ | No | NA | Daclizumab majority; alemtuzumab small minority | CNI/prednisone or some with FK + (MMF or rapamycin) | Some | ND | NA |
| 72 DSA− | ||||||||
| Higgins et al., 20117 | 23 DSA+ | Yes | >500 | basiliximab | FK + MMF + prednisone | No | ND | 3 yr eGFR, 46.9 |
| 28 DSA− | 3 yr eGFR, 56.7 | |||||||
| Gibney et al., 200615 | 20 DSA+ | No | NA | 52% rATG, 15% CD25 monoclonal antibody | 70% FK/rapamycin/prednisone, 30% CNI + (rapamycin or MMF) + prednisone entire cohort | No | ND | NA |
| 35 DSA− | ||||||||
| van den Berg-Loonen et al., 200818 | 13 DSA+ | No | NA | None | CNI + (azathioprine or MMF or rapamycin) + prednisone | No | ND | NA |
| 14 DSA− | ||||||||
| Aubert et al., 200913 | 11 DSA+ | No | >500 | Basiliximab: first kidney transplant; or rATG: retransplant or panel-reactive antibody>50% | FK + MMF + prednisone | No | Yes (44 patients) | NA |
| 102 DSA− | ||||||||
| Amico et al., 200912 | 67 DSA+ | No | >500 | 52% none, 39% basiliximab, 9% daclizumab | No | ND | NA | |
| 267 DSA− | ||||||||
| Mahmoud et al., 2009177 | 16 DSA+ | No | NA | None | Steroid + azathioprine + (CNI or rapamycin) | No | Yes | 3 yr Cr, 2.5 |
| 137 DSA− | 3 yr Cr, 1.5 | |||||||
| Lefaucheur et al., 201016 | 76 DSA+ | Yes | >300 (normalized) | rATG | CNI + MMF + steroids | No | Yes | NA |
| 326 DSA− | ||||||||
| Dunn et al., 201119 | 46 DSA+ | No | NA | rATG (4–6 mg/kg) | CNI + MPA | Yes | Yes | NA |
| 541 DSA− | >500 (baseline adjusted) | |||||||
| Caro-Orleas et al., 201214 | 103 DSA+ | No | >1500 (raw) | 1993–1996, rATG; 1997 onward: for high immunologic risk, rATG; for moderate immunologic risk, daclizumab or basiliximab | CNI + (azathioprine or MMF) + steroids | No | Yes | NA |
| 780 DSA− | ||||||||
| Bielmann et al., 200726 | 9 DSA+ | No | NA | rATG | FK + MMF + steroids | No | Yes | 1.1 |
| 56 DSA− | Basiliximab | Yes | 1.3 | |||||
| Billen et al., 200927 | 32 DSA+ | No | >1000 | No induction; 5 received basiliximab | 50% CNI (FK majority) + prednisolone; 50% receiving CNI + prednisolone + azathioprine/MMF/rapamycin | No | ND | NA |
| 133 DSA− | ||||||||
| Morris et al., 201028 | 15 DSA+ | No | NA | rATG | MMF, FK, prednisone | No | Yes | NA |
| 134 DSA− | ||||||||
| Vlad et al., 200910 | 14 DSA+ | No | 1000±500 | rATG (6 mg/kg) | FK, MMF, steroids tapered on day 5 | Yes | ND | NA |
| 265 DSA− | ||||||||
| Higgins et al., 20117 | 44 DSA+ | Yes | >500 | Basiliximab | FK + MMF + prednisone | No | ND | 3 yr eGFR, 54.2 |
| 28 DSA− | 3 yr eGFR, 56.7 |
Renal function reported as creatinine mg/dl unless otherwise stated; estimated GFR reported as ml/min. MFI, mean fluorescence intensity; NA, not applicable; CSA, cyclosporine A; ND, not discussed; rATG, rabbit antithymocyte globulin; FK, tacrolimus; MMF, mycophenolate mofetil; CNI, calcineurin inhibitor; eGFR, estimated GFR; Cr, creatinine.