Table 2.
C4d-Negative AMR (n=51) |
C4d-Positive AMR (n=156) |
P-value | ||
---|---|---|---|---|
Transplant Type | 0.7 | |||
Live Donor | ||||
Compatible | 2 (3.9%) | 4 (2.6%) | ||
HLA-Incompatible | 34 (66.7%) | 101 (64.7%) | ||
ABO-Incompatiblea | 1 (2.0%) | 11 (7.0%) | ||
Deceased Donor | ||||
Compatible | 3 (5.9%) | 11 (7.0%) | ||
HLA-Incompatible | 11 (21.6%) | 29 (18.6%) | ||
Prior Transplant | 28 (54.9%) | 88 (56.4%) | 0.8 | |
Median PRA (IQR) | 93 (88–100) | 96 (73–100) | 0.9 | |
Zero HLA Mismatch | 0 (0.0%) | 1 (0.6%) | 0.6 | |
Pre-Desensitization Antibody Strengthb | 0.7 | |||
CDC+ | 11 (24.4%) | 39 (29.8%) | ||
FCXM+ | 23 (51.1%) | 66 (50.4%) | ||
Luminex+ | 11 (24.4%) | 26 (19.8%) | ||
Induction | 0.6 | |||
Thymoglobulin | 26 (63.4%) | 90 (63.8%) | ||
Daclizumab | 12 (29.3%) | 46 (32.6%) | ||
Basiliximab | 3 (7.3%) | 5 (3.5%) | ||
HLA Antibody Classb | 0.4 | |||
Class I | 16 (33.3%) | 41 (28.3%) | ||
Class II | 14 (29.2%) | 33 (22.8%) | ||
Class I and II | 18 (37.5%) | 71 (49.0%) | ||
Median Number of Biopsiesc (IQR) | 5 (2–6) | 5 (4–7) | 0.05 | |
Clinical Presentation of AMRd | 28 (54.9%) | 133 (85.3%) | <0.001 | |
AMR Treated | 16 (31.4%) | 118 (75.6%) | <0.001 | |
Death-Censored Graft Loss | 0.4 | |||
1 Year Post AMR-Defining Biopsy | 93.4% (80.8–97.8%) | 86.8% (80.1–91.4%) | ||
2 Years Post AMR-Defining Biopsy | 90.2% (75.7–96.3%) | 82.6% (75.0–88.0%) | ||
3 Years Post AMR-Defining Biopsy | 90.2% (75.7–96.3%) | 77.7% (69.3–84.0%) |
AMR - antibody-mediated rejection, IQR - interquartile range, CDC+ - complement-dependent cytotoxic crossmatch, FCXM+ - flow cytometric crossmatch
ABO-incompatible recipients who also had anti-HLA DSA were studied as members of the incompatible live donor group.
Percentages are of those patients with anti-HLA DSA (live and deceased donor recipients).
Median number of biopsies performed for the duration of follow-up for the life of the allograft.
Clinical episodes of AMR were defined as those that had evidence of graft dysfunction, manifested as an increase in serum creatinine by ≥20% from baseline, treatment of cell-mediated rejection and/or thrombotic microangiopathy within the two prior weeks, the need for hemodialysis >7 days post-transplant, or new onset proteinuria at the time of the AMR-defining biopsy.