Table 1.
Characteristics of patients with living and deceased kidney transplantation stratified according to presence and strength of DSA
| Variable | Living Donation, n=1324 | Deceased Donation, n=2808 | ||||||
|---|---|---|---|---|---|---|---|---|
| No DSA | DSA <3000 MFI | DSA ≥3000 MFI | Missing Data, n | No DSA | DSA <3000 MFI | DSA ≥3000 MFI | Missing Data, n | |
| Patient age, yr | 46 (33–55) | 49 (34–55) | 46 (37–53) | 0 | 56 (46–65) | 54 (44–65) | 55 (43–65) | 0 |
| Patient sex, women | 439 (36) | 29 (49) | 23 (49) | 0 | 977 (38) | 71 (49) | 62 (54) | 0 |
| Current % PRA | 0 (0–0) | 0 (0–0) | 0 (0–28) | 4 | 0 (0–0) | 0 (0–24) | 15 (0–73) | 0 |
| Highest % PRA | 0 (0–0) | 2 (0–19) | 33 (1–82) | 4 | 0 (0–6) | 10 (0–79) | 57 (10–95) | 0 |
| DSA strength, maximum MFI | n.a. | 1142 (680–1683) | 6198 (4400–11,485) | 0 | n.a. | 1177 (657–2000) | 7400 (4357–12,057) | 0 |
| DSA strength, cumulative MFI | n.a. | 1200 (680–1807) | 7900 (4579–13,700) | 0 | n.a. | 1279 (774–2049) | 9400 (5783–15,700) | 0 |
| DSA class, n (%) | 0 | 0 | ||||||
| Class 1 only | n. a. | 29 (49) | 16 (34) | n. a. | 85 (58) | 54 (47) | ||
| Class 2 only | n. a. | 25 (42) | 18 (38) | n. a. | 46 (32) | 25 (22) | ||
| Class 1 and 2 | n. a. | 5 (8) | 13 (28) | n. a. | 15 (10) | 35 (30) | ||
| Retransplant, n (%) | 64 (5) | 11 (19) | 10 (21) | 0 | 252 (10) | 43 (29) | 47 (41) | 0 |
| Preemptive transplantation, n (%) | 388 (32) | 19 (32) | 9 (19) | 0 | n.a. | n.a. | n.a. | n.a. |
| Time on dialysis, yr | 0 (0–1) | 0 (0–1) | 1 (0–2) | 0 | 5 (3–8) | 5 (3–8) | 6 (3–9) | 62 |
| Donor age, yr | 53 (47–60) | 52 (45–58) | 53 (47–57) | 0 | 55 (44–66) | 57 (48–66) | 51 (34–63) | 0 |
| Donor sex, women | 738 (61) | 38 (64) | 20 (43) | 0 | 1201 (47) | 77 (53) | 54 (47) | 0 |
| Kidney Donor Risk Index (11) | n. a. | n. a. | n. a. | n. a. | 1.3 (1.0–1.9) | 1.4 (1.1–1.9) | 1.3 (1.0–1.8) | 484 |
| Cold ischemic period, min | 151 (120–180) | 150 (120–180) | 133 (117–183) | 32 | 713 (527–900) | 717 (495–920) | 782 (531–977) | 43 |
| No. of mismatches for HLA-A/B/DR | 3 (2–4) | 4 (3–5) | 4 (3–5) | 133 | 3 (2–4) | 3 (2–4) | 3 (3–4) | 1 |
| Induction therapy, n (%) | 164 | 255 | ||||||
| None | 177 (17) | 7 (13) | 3 (6) | 308 (13) | 13 (9) | 5 (4) | ||
| ATG | 62 (6) | 8 (14) | 11 (23) | 410 (18) | 41 (29) | 48 (42) | ||
| IL-2 | 671 (63) | 29 (52) | 16 (34) | 1538 (67) | 77 (54) | 41 (36) | ||
| CD20 | 15 (1) | 0 (0) | 4 (9) | 2 (0) | 1 (1) | 0 (0) | ||
| CD52 | 0 (0) | 0 (0) | 0 (0) | 6 (0) | 2 (1) | 5 (4) | ||
| IL-2 and CD20 | 119 (11) | 11 (19) | 7 (15) | 6 (0) | 3 (2) | 2 (2) | ||
| Further combinationa | 13 (1) | 1 (2) | 6 (13) | 27 (1) | 5 (4) | 13 (11) | ||
| Initial immunosuppression, n (%) | 165 | 512 | ||||||
| CsA/MMF/steroids | 141 (13) | 3 (5) | 1 (2) | 508 (22) | 21 (15) | 6 (5) | ||
| Tac/MMF/steroids | 751 (71) | 44 (79) | 40 (85) | 1434 (63) | 104 (73) | 87 (76) | ||
| Other | 164 (16) | 9 (16) | 6 (13) | 354 (15) | 17 (12) | 21 (18) | ||
| Desensitization, n (%) | 2 | 1 | ||||||
| No desensitization | 915 (75) | 36 (61) | 26 (55) | 2456 (96) | 137 (94) | 95 (83) | ||
| ABO-incompatible transplantation | 266 (22) | 13 (22) | 9 (19) | 1 (0)b | 0 (0) | 0 (0) | ||
| Other desensitization | 35 (3) | 10 (17) | 12 (26) | 89 (3) | 9 (6) | 20 (17) | ||
Data are displayed as number of patients (%) or median (interquartile range). DSA, donor-specific HLA antibodies; MFI, medium fluorescence intensity; PRA, panel-reactive antibodies; n.a., not applicable; ATG, antithymocyte globulin; CD20, CD20 receptor antagonist (rituximab); CD52, CD52 receptor antagonist; CsA, cyclosporin A; MMF, mycophenolate mofetil; Tac, tacrolimus.
Ten living donation patients without DSA (one with DSA <3000 MFI and six with DSA ≥3000 MFI) received a further combined induction therapy including ATG, as well as 27 deceased donation patients without DSA (five with DSA <3000 MFI and 13 with DSA ≥3000 MFI); 12 living donation patients without DSA (one with DSA <3000 MFI and six with DSA ≥3000 MFI) received a further combined induction therapy including CD20, as well as 14 deceased donation patients without DSA (two with DSA <3000 MFI and nine with DSA ≥3000 MFI).
ABO-incompatible transplantation because of clerical error.