Table 1.
Characteristics of 9052 transplant recipients included in the analysis.
| Whole sample (n=9052) | No AGPN (n=7286) | First AGPN in the first 6-months post-transplantation (n=954) | First AGPN after 6-months post-transplantation (n=812) | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NA | n | % | NA | n | % | NA | n | % | NA | n | % | ||
| Recipient characteristics | |||||||||||||
| Recipient age (SD) | 0 | 51.0 (14.1) | 0 | 50.6 (14.1) | 0 | 53.5 (14.3) | 0 | 51.5 (14.3) | |||||
| Recipient age ≥55 years | 0 | 4001 | 44.2 | 0 | 3110 | 42.7 | 0 | 517 | 54.2 | 0 | 374 | 46.1 | |
| Retransplantation | 0 | 1309 | 14.5 | 0 | 1007 | 13.8 | 0 | 154 | 16.1 | 0 | 148 | 18.2 | |
| Male sex | 0 | 5743 | 63.4 | 0 | 4963 | 68.1 | 0 | 452 | 47.4 | 0 | 328 | 40.4 | |
| Kidney transplantation (vs SPK transplantation) | 0 | 8508 | 94.0 | 0 | 6840 | 93.9 | 0 | 898 | 94.1 | 0 | 770 | 94.8 | |
| Renal replacement therapy | 30 | 29 | 0 | 1 | |||||||||
| • Hemodialysis | 6749 | 74.8 | 5408 | 74.5 | 731 | 76.6 | 610 | 75.2 | |||||
| • Peritoneal dialysis | 824 | 9.1 | 682 | 9.4 | 76 | 8.0 | 66 | 8.1 | |||||
| • Preemptive transplantation | 1449 | 16.1 | 1167 | 16.1 | 147 | 15.4 | 135 | 16.6 | |||||
| Recurrent initial nephropathy | 0 | 2209 | 24.4 | 0 | 1855 | 25.5 | 0 | 191 | 20.0 | 0 | 163 | 20.1 | |
| History of diabetes | 0 | 2179 | 24.1 | 0 | 1729 | 23.7 | 0 | 238 | 24.9 | 0 | 212 | 26.1 | |
| Urological history | 0 | 999 | 11.0 | 0 | 722 | 9.9 | 0 | 149 | 15.6 | 0 | 128 | 15.8 | |
| Use of ureteral stent | 245 | 7246 | 80.0 | 223 | 5844 | 80.2 | 14 | 775 | 81.2 | 8 | 627 | 77.2 | |
| Positive recipient CMV serology | 109 | 5867 | 65.6 | 87 | 4724 | 65.6 | 7 | 636 | 67.2 | 15 | 507 | 63.6 | |
| Donor characteristics | |||||||||||||
| Deceased donor | 0 | 7510 | 83.0 | 0 | 5963 | 81.8 | 0 | 834 | 87.4 | 0 | 713 | 87.8 | |
| Donor age (SD) | 32 | 52.1 (16.4) | 28 | 51.6 (16.3) | 4 | 54.9 (16.2) | 0 | 53.2 (16.6) | |||||
| Donor age ≥55 years | 32 | 4209 | 46.7 | 28 | 3280 | 45.2 | 4 | 516 | 54.3 | 0 | 413 | 50.9 | |
| Male donor | 12 | 5044 | 55.8 | 12 | 4049 | 55.7 | 0 | 539 | 56.5 | 0 | 456 | 56.2 | |
| Positive donor CMV serology | 22 | 4964 | 55.0 | 19 | 3968 | 54.6 | 1 | 544 | 57.1 | 2 | 452 | 55.8 | |
| Cold ischemia time ≥18 hours | 83 | 2653 | 29.6 | 70 | 2041 | 28.3 | 7 | 321 | 33.9 | 6 | 291 | 36.1 | |
| Immunosuppression and prophylaxis at transplantation | |||||||||||||
| Cold ischemia (SD) | 83 | 14.5 (8.1) | 70 | 14.2 (8.1) | 7 | 115.7 (8.0) | 6 | 15.9 (8.0) | |||||
| Depleting induction at transplantation | 43 | 5752 | 63.8 | 40 | 4602 | 63.5 | 3 | 623 | 65.5 | 0 | 527 | 64.9 | |
| Maintenance immunosuppressive treatment at transplantation | |||||||||||||
| • Ciclosporine | 43 | 1594 | 17.6 | 40 | 1290 | 17.7 | 3 | 156 | 16.6 | 0 | 148 | 18.22 | |
| • Tacrolimus | 43 | 7407 | 82.2 | 40 | 5947 | 82.1 | 3 | 796 | 83.7 | 0 | 664 | 81.8 | |
| • mTOR inhibitors | 43 | 342 | 3.7 | 40 | 285 | 3.9 | 3 | 39 | 4.1 | 0 | 24 | 3.0 | |
| • Anti-proliferatives | 43 | 8713 | 96.2 | 40 | 6993 | 96.0 | 3 | 924 | 96.9 | 0 | 796 | 98.0 | |
| • Oral corticoids | 43 | 8635 | 95.39 | 40 | 6965 | 95.6 | 3 | 907 | 95.1 | 0 | 763 | 94.0 | |
| CMV prophylaxis treatment at transplantation | 424 | 5722 | 66.3 | 381 | 4584 | 66.4 | 23 | 646 | 69.4 | 20 | 492 | 62.1 | |
| Immunology | |||||||||||||
| Immunization pre-transplantation | 1019 | 831 | 90 | 98 | |||||||||
| • Positive anti-HLA Ab no DSA | 3410 | 42.4 | 2719 | 42.1 | 369 | 42.7 | 322 | 45.1 | |||||
| • Positive DSA | 1061 | 13.2 | 829 | 12.8 | 149 | 17.2 | 83 | 11.6 | |||||
| • Negative anti-HLA Ab | 3562 | 44.3 | 2907 | 45.0 | 346 | 40.0 | 309 | 43.3 | |||||
| HLA-A-B-DR mismatches > 4 | 80 | 1660 | 18.5 | 69 | 1336 | 18.5 | 8 | 193 | 20.4 | 3 | 131 | 16.2 | |
| Pregnancy history | 1039 | 1734 | 21.6 | 709 | 1217 | 18.5 | 149 | 273 | 33.9 | 181 | 244 | 38.7 | |
| Post-transplantation outcomes | |||||||||||||
| Delayed graft function | 589 | 1878 | 22.2 | 549 | 1422 | 21.1 | 20 | 272 | 29.1 | 20 | 184 | 23.2 | |
| At least one rejection | 0 | 2018 | 22.3 | 0 | 1524 | 20.9 | 0 | 253 | 26.5 | 0 | 239 | 29.4 | |
| Number of rejection (SD) | 0 | 0.3 (0.7) | 0 | 0.3 (06) | 0.4 (0.7) | 0.4 (0.9) | |||||||
| Treatment of rejection | 0 | 2018 | 22.3 | 0 | 1526 | 20.9 | 0 | 253 | 26.5 | 0 | 239 | 29.4 | |
| • No treatment | 0 | 546 | 6.0 | 0 | 423 | 5.8 | 0 | 63 | 6.6 | 0 | 60 | 7.3 | |
| • Oral corticoids | 0 | 890 | 9.8 | 0 | 658 | 9.0 | 0 | 116 | 12.8 | 0 | 116 | 14.2 | |
| • Anti-thymoglobulin | 0 | 81 | 0.9 | 0 | 74 | 1.0 | 0 | 7 | 0.7 | 0 | 0 | 0 | |
| • Others treatments (IVIg, Rituximab, plasmapheresis) | 0 | 501 | 5.5 | 0 | 371 | 5.1 | 0 | 67 | 7.0 | 0 | 63 | 7.7 | |
| At least one CMV infection | 0 | 1314 | 14.5 | 0 | 962 | 13.2 | 0 | 186 | 19.5 | 0 | 166 | 20.4 | |
| Cause of death | 0 | 758 | 8.3 | ||||||||||
| • Cardio-vascular | 0 | 172 | 1.9 | ||||||||||
| • Malignancy | 0 | 192 | 2.1 | ||||||||||
| • Infections | 0 | 160 | 1.8 | ||||||||||
| • Others | 0 | 96 | 1.1 | ||||||||||
| • Undetermined | 0 | 138 | 1.5 | ||||||||||
AGPN, acute graft pyelonephritis; CMV, cytomegalovirus; CNI, calcineurine inhibitor; DSA, donor-specific antibodies; HLA, human leucocyte antigens; SD: standard deviation; NA, not available (missing).