Table 1.
Baseline characteristics, immunosuppression management, and transplant characteristics of 103 pediatric renal transplants performed 12/1/2008–12/31/2013, subdivided by subsequent diagnosis of dnDSA and clinical stability at time of dnDSA detection.
| No dnDSA n=70 |
dnDSA detected on
screening n=20 |
dnDSA detected on for-cause
testing n=13 |
|
|---|---|---|---|
| Age (years) (median (IQR)) | 12.2 (7.4–14.8) | 6.8 (3.8–16.3) | 16 (6.5–16.3) |
| Male (n(%)) | 44 (63%) | 15 (75%) | 8 (62%) |
| Caucasian (n(%)) | 46 (66%) | 11 (55%) | 6 (46%) |
| ESRD cause (n(%)) | |||
| CAKUT | 36 (54%) | 9 (45%) | 8 (65%) |
| Other | 34 (46%) | 11 (55%) | 5 (35%) |
| Deceased donor transplant (n(%)) | 31 (44%) | 10 (50%) | 11 (85%) |
| Induction(n(%)) | |||
| Thymoglobulin | 56 (80%) | 17 (85%) | 8 (62%) |
| IL-2 blockade | 14 (20%) | 3 (15%) | 5 (38%) |
| # of thymoglobulin doses (mean(sd)) | 4.4 (1.2) | 4.6 (1.1) | 4.8 (1.6) |
| Steroids at induction (n(%)) | 61 (87%) | 19 (95%) | 12 (92%) |
| Maintenance MMF (n(%)) | 70 (100%) | 20 (100%) | 13 (100%) |
| Maintenance Immunosuppression (n(%)) | |||
| Tacrolimus | 68 (97%) | 19 (95%) | 13 (100%) |
| Sirolimus | 2 (3%) | 1 (5%) | 0 (0%) |
| Maintenance steroids (n(%)) | 4 (6%) | 1 (10%) | 0 (0%) |
| Warm ischemia time (min) (median (IQR)) | 56 (44–67) | 52 (45–59) | 51 (47–60) |
| Cold ischemia time (min) (median (IQR)) | 178 (126–714) | 449 (139–691) | 698 (494–996) |
| Delayed graft function (n(%)) | 4 (6%) | 3 (15%) | 0 (0%) |
| cPRA (median(IQR)) | 0 (0–0) | 0 (0–0) | 0 (0–0) |
| # Class I HLA mismatches (mean(sd)) | 4.2 (1.6) | 4.8 (1.2) | 4.9 (1.1) |
| # DQ mismatches (mean(sd)) | 1.2 (0.73) | 1.2 (0.75) | 1.2 (0.69) |
| # DR mismatches (mean(sd)) | 0.8 (0.73) | 1 (0.73) | 0.9 (0.86) |
| EBV D+/R− (n(%)) | 21 (30%) | 9 (45%) | 2 (20%) |
| CMV D+/R− (n(%)) | 20 (29%) | 9 (45%) | 4 (33%) |
| Baseline eGFR (ml/min/1.73m2) (mean(sd)) | 85.7 (21.2) | 93.9 (36.6) | 89.0 (20.1) |
| Renal biopsies in 2 years (median(IQR)) | 3 (2–4) | 4 (2.5–4.5) | 4 (3–5) |
| Time in Study (years) (mean(sd)) | 4.5 (1.6) | 4.5 (1.7) | 3.2 (1.8) |
ESRD: End-stage renal disease; MMF: mycophenolate mofetil; cPRA: calculated panel reactive antibodies; D+/R-: Donor positive/recipient negative