Table 3.
Impact of reduced exposure to CNI on the occurrence of de novo DSA in a multivariablea Cox adjusted model
| Event | Reduced exposure to CNI | Nb events/Nb patients | Univariate model | Multivariate modela | ||
|---|---|---|---|---|---|---|
| HR (CI 95%) | p | HR (CI 95%) | p | |||
| First detection of one DSA with MFI > 1000 | No | 2/81 (2.5%) | 1.00 | 1.00 | ||
| Yes | 35/166 (21.1%) | 10.43 (2.50–43.46) | 0.001 | 9.77 (2.34–40.77) | 0.002 | |
| First detection of one DSA with MFI > 6000 | No | 1/82 (1.2%) | 1.00 | 1.00 | ||
| Yes | 22/165 (13.3%) | 12.31 (1.66–91.47) | 0.014 | 11.54 (1.55–85.93) | 0.017 | |
| First detection of one DSA with MFI > 10,000 | No | 1/84 (1.2%) | 1.00 | 1.00 | ||
| Yes | 16/163 (9.8%) | 8.86 (1.17–66.92) | 0.034 | 7.40 (0.97–56.31) | 0.053 | |
| First detection of DSA(s) with total MFI > 6000 | No | 1/82 (1.2%) | 1.00 | 1.00 | ||
| Yes | 23/165 (13.9%) | 12.81 (1.73–94.97) | 0.013 | 12.02 (1.62–89.25) | 0.015 | |
| First detection of DSA(s) with total MFI > 10,000 | No | 1/83 (1.2%) | 1.00 | 1.00 | ||
| Yes | 19/164 (11.6%) | 10.75 (1.44–80.43) | 0.021 | 9.50 (1.26–71.43) | 0.029 | |
| First rejection | No | 1/83 (1.2%) | 1.00 | 1.00 | ||
| Yes | 11/164 (6.7%) | 5.65 (0.73–43.74) | 0.097 | 5.65 (0.73–43.74) | 0.097 | |
| Post-transplant neoplasia | No | 10/88 (11.4%) | 1.00 | 1.00 | ||
| Yes | 18/159 (11.3%) | 1.16 (0.53–2.52) | 0.71 | 1.20 (0.55–2.62) | 0.64 | |
| Post-transplant neoplasia (excluding skin neoplasia) | No | 8/88 (9.1%) | 1.00 | 1.00 | ||
| Yes | 10/159 (6.3%) | 0.75 (0.30–1.91) | 0.55 | 0.75 (0.30–1.91) | 0.55 | |
| Return in dialysis | No | 3/87 (3.4%) | 1.00 | 1.00 | ||
| Yes | 15/160 (9.4%) | 3.22 (0.93–11.22) | 0.066 | 3.22 (0.93–11.22) | 0.066 | |
| Patient survival | No | 9/87 (10.3%) | 1.00 | 1.00 | ||
| Yes | 13/160 (8.1%) | 1.01 (0.43–2.38) | 0.97 | 1.03 (0.44–2.43) | 0.94 | |
| Graft survival | No | 12/87 (13.8%) | 1.00 | 1.00 | ||
| Yes | 28/160 (17.5%) | 1.57 (0.80–3.11) | 0.19 | 1.64 (0.82–3.28) | 0.16 | |
DSA: Donor Specific Antibody, MFI Mean Fluorescence Intensity. Results with p value less than 5% were emphasized using bold letters
aMultivariable analyses were performed using iterative backward selection, by forcing “reduced exposure to CNI” in the Cox model, with the following variables as candidate covariates: number of HLA mismatches, donor type (living, deceased -standard or extended criteria-), age and gender of the recipient, mycofenolic acid cessation, delayed graft function and induction therapy