Table 1.
Patient demographics
| Variables | AMVR without anti-HLA DSAs, n=38 | AMVR with anti-HLA DSAs, n=20 | P Values |
|---|---|---|---|
| Recipient characteristics | |||
| Men, n (%) | 25 (65.8) | 13 (65.0) | 1.00 |
| Age at transplantation, mean±SD, yr | 43.0±14.3 | 50.4±15.9 | 0.11 |
| Cause of ESRD, n (%) | |||
| GN | 10 (26.3) | 4 (20.0) | 0.75 |
| Diabetes | 6 (15.8) | 5 (25.0) | 0.49 |
| Cystic/hereditary/congenital | 7 (18.4) | 3 (15.0) | 1.00 |
| Secondary GN | 3 (7.9) | 2 (10.0) | 1.00 |
| Hypertension | 2 (5.3) | 0 (0.0) | 0.54 |
| Interstitial nephritis | 3 (7.9) | 2 (10.0) | 1.00 |
| Miscellaneous conditions | 2 (5.4) | 3 (15.0) | 0.33 |
| Uncertain etiology | 5 (13.2) | 1 (5.0) | 0.65 |
| Duration of dialysis before transplantation, mean±SD, yr | 3.9±4.4 | 4.8±4.9 | 0.44 |
| Previous transplantation, n (%) | 10 (26.3) | 3 (15.0) | 0.51 |
| Transplant variables | |||
| Donor age, mean±SD, yr | 50.4±12.6 | 52.3±17.4 | 0.93 |
| Deceased donor, n (%) | 28 (73.7) | 17 (85.0) | 0.51 |
| Male donor, n (%) | 17 (44.7) | 8 (40.0) | 0.79 |
| Cold ischemia time, mean±SD, h | 15.9±10.4 | 20.5±9.7 | 0.13 |
| Preformed anti-HLA Abs with an MFI>500, n (%) | 19 (50.0) | 20 (100.0) | <0.001 |
| Delayed graft function, n (%) | 18 (47.3) | 7 (35.0) | 0.41 |
| Number of post-transplant hemodialysis session, mean±SD | 2.5±4.2 | 2.4±2.9 | 0.39 |
| Immunosuppressive protocol | |||
| Induction therapy, n (%) | 38 (100.0) | 19 (95.0) | 0.34 |
| Basiliximab/thymoglobuline, n (%) | 33 (86.8)/5 (13.2) | 14 (75.0)/5 (25.0) | 0.28 |
| Calcineurin inhibitor-based therapy, n (%) | 37 (97.4) | 20 (100.0) | 1.0 |
| Cyclosporine/tacrolimus, n (%) | 11 (28.9)/26 (68.4) | 3 (15.0)/17 (85.0) | 0.34 |
| Purine synthesis inhibitor, n (%) | 37 (93.9) | 19 (95.0) | 0.35 |
| mTOR inhibitor, n (%) | 0 (0.0) | 1 (5.0) | 0.35 |
| Steroid, n (%) | 37 (97.4) | 20 (100.0) | 1.0 |
| Acute rejection description | |||
| Best serum creatinine level before AMVR, mean±SD, µmol/L | 275±187 | 195±137 | 0.15 |
| Best serum creatinine level before AMVR, mean±SD, d | 15.7±21.4 | 8.5±8.2 | 0.64 |
| AMVR diagnosis, mean±SD, d | 22.0±26.2 | 15.9±13.5 | 0.92 |
| Serum creatinine level at rejection, mean±SD, µmol/L | 417±276 | 298±229 | 0.11 |
| Patients on dialysis at time of rejection | 8 (21.1) | 1 (0.05) | 0.14 |
| Acute rejection treatment | |||
| Steroid, n (%) | 35 (92.1) | 19 (95.0) | 1.00 |
| Thymoglobuline, n (%) | 10 (26.0) | 2 (10.0) | 0.19 |
| Rituximab, n (%) | 12 (31.6) | 10 (50.0) | 0.25 |
| Plasmapheresis, n (%) | 25 (65.8) | 15 (75.0) | 0.56 |
| IGIV, n (%) | 18 (47.4) | 17 (85.0) | 0.01 |
| Follow-up | |||
| Serum creatinine level at 3 mo post-Tx, mean±SD, µmol/L | 161±59 | 129±55 | 0.01 |
| Serum creatinine level at 12 mo post-Tx, mean±SD, µmol/L | 145±53 | 125±41 | 0.08 |
| Mean follow-up, mean±SD, yr | 4.3±3.0 | 3.5±2.7 | 0.25 |
| Serum creatinine level at the last follow-up, mean±SD, µmol/L | 169±97 | 136±76 | 0.23 |
| Proteinuria at the last follow-up, mean±SD, g/g creatininea | 1.27±1.7 (n=20) | 1.0±1.4 (n=18) | 0.44 |
| Patient survival at the last follow-up, n (%) | 37 (97.3) | 18 (90.0) | 0.12 |
| Graft survival at the last follow-up, n (%) | 29 (76.3) | 19 (95.0) | 0.51 |
MFI, mean fluorescence intensity; mTOR, mammalian target of rapamycin; IGIV, IG intravenous; post-Tx, post-transplant.
a
In patients with a follow-up >1 yr.