Table 4.
Univariate and multivariate Cox regression for death-censored graft loss
| Variable | Univariate |
Multivariate |
||||
|---|---|---|---|---|---|---|
| HR | 95% CI | P | HR | 95% CI | P | |
| Recipient age (yr) | 0.96 | 0.93–1.00 | 0.051 | 0.95 | 0.92–0.99 | 0.028 |
| Donor age (yr) | 1.015 | 0.98–1.053 | 0.42 | |||
| Time on dialysis (mo) | 1.006 | 0.998–1.013 | 0.13 | |||
| Transplant number >1 versus 1 | 2.23 | 0.93–5.35 | 0.071 | 1.97 | 0.71–5.44 | 0.19 |
| Child to mother or husband to wife versus other types of donors | 2.23 | 0.29–16.70 | 0.43 | |||
| eGFR 6 mo (ml/min per 1.73 m2) | 0.97 | 0.94–0.99 | 0.009 | 0.96 | 0.93–0.99 | 0.005 |
| HLA allele mismatches | 0.93 | 0.69–1.27 | 0.67 | |||
| Class I | 1.03 | 0.65–1.62 | 0.89 | |||
| Class II | 0.79 | 0.43–1.45 | 0.44 | |||
| HLA eplet mismatches | ||||||
| Class I (A, B) | 1.03 | 0.95–1.11 | 0.48 | |||
| Class II: DR | 1.01 | 0.927–1.09 | 0.86 | |||
| DQ | 1.01 | 0.93–1.09 | 0.78 | |||
| Induction treatment: rATG | 1.62 | 0.63–4.13 | 0.31 | |||
| Desensitization therapy: yes | 3.81 | 1.09–13.30 | 0.036 | 3.57 | 0.52–24.4 | 0.19 |
| CDC-XM + prior to desensitization | 3.44 | 0.46–25.92 | 0.23 | |||
| Acute rejection | 8.47 | 3.39–21.12 | <0.001 | 6.68 | 2.51–17.78 | <0.001 |
| CDC-PRA > 20% | 3.01 | 1.19–7.64 | 0.020 | 1.59 | 0.45–5.60 | 0.48 |
| CDC-PRA >80% | 1.028 | 1.13–8.08 | 0.97 | |||
| FC-XM anti T or B+ | 5.81 | 1.66–20.34 | 0.006 | 3.43 | 0.58–20.27 | 0.17 |
| DSA+ | 4.42 | 1.69–11.52 | 0.002 | 2.23 | 0.50–18.38 | 0.23 |
| DSA-C3d+ | 4.31 | 1.24–14.99 | 0.022 | 2.61 | 0.36–18.57 | 0.34 |
| DSA MFI > 6190a | 5.07 | 1.46–17.67 | 0.011 | 2.20 | 0.33–14.81 | 0.42 |
| FC-XM+/DSA+b | 6.56 | 1.88–22.86 | 0.003 | 3.99 | 0.86–18.66 | 0.07 |
| FC-XM+/DSA-C3d+b | 5.67 | 1.29–24.87 | 0.021 | 2.89 | 0.52–15.99 | 0.22 |
CDC-PRA, complement-dependent cytotoxicity panel-reactive antibody; CDC-XM, complement-dependent cytotoxicity crossmatch; CI, confidence interval; DSA, donorspecific antibody (solid phase assay); DSA-C3d, C3d-binding donor-specific antibody; eGFR, estimated glomerular filtration rate; FC-XM, flow cytometry crossmatch; HR, hazard ratio; MFI, mean fluorescence intensity; rATG, rabbit anti-thymocyte globulin (Thymoglobulin).
In the multivariate Cox regression model excluding acute rejection and analyzing all tests individually (adjusted for recipient age, transplant number, eGFR 6 mo, and desensitization therapy), only FC-XM+/DSA+ was independently predicting graft loss (HR = 8.01, 95% CI = 1.27–50.48, P = 0.027).
Analysis adjusted for recipient age, transplant number, eGFR 6 mo, desensitization therapy, acute rejection, CDC-PRA>20%, FC-XM+, DSA+.
Analysis adjusted for recipient age, transplant number, eGFR 6 mo, desensitization therapy, acute rejection, and CDC-PRA > 20%.