Table 2.
Univariable and multivariable analyses of the associations with recurrent disease in patients with kidney failure secondary to IgAN
| Variable | Univariable (n = 282) |
Multivariable (n = 267), N events = 69 |
|||
|---|---|---|---|---|---|
| N events | HR (95% CI) | p value | aHR (95% CI) | p value | |
| Recipient age at transplant, per each year | 80 | 0.96 (0.94–0.98) | <0.001 | 0.96 (0.94–0.98) | 0.001 |
| Recipient, female gender | 80 | 1.16 (0.73–1.85) | 0.52 | ||
| Recipient, European ancestry | 79 | 1.39 (0.86–2.25) | 0.18 | ||
| Donor, European ancestry | 62 | 1.09 (0.62–1.93) | 0.77 | ||
| Allograft source | 80 | ||||
| Deceased donor | Ref | − | |||
| Living-related | 1.29 (0.80–2.11) | 0.3 | |||
| Living-unrelated | 1.16 (0.62–2.19) | 0.64 | |||
| Medical sites | 80 | ||||
| CUIMC | Ref | − | Ref | − | |
| OHSU | 1.36 (0.83–2.22) | 0.23 | 1.06 (0.56–2.02) | 0.86 | |
| HUC | 0.70 (0.31–1.55) | 0.37 | 0.59 (0.25–1.37) | 0.22 | |
| Year of transplantation | 80 | 1.05 (1.00–1.08) | 0.06 | 1.08 (1.02–1.14) | 0.006 |
| # HLA matches (per antigen: 0–6) | 80 | 1.15 (1.02–1.30) | 0.02 | 1.12 (0.98–1.29) | 0.11 |
| Induction with thymoglobulin1 | 69 | 0.65 (0.40–1.06) | 0.08 | 0.65 (0.36–1.15) | 0.14 |
| Steroid-free regimens | 80 | 0.77 (0.48–1.24) | 0.28 | ||
| Acute rejection* | 80 | 0.90 (0.55–1.46) | 0.66 | ||
| Recipient HLA-B35 | 80 | 1.40 (0.87–2.27) | 0.17 | ||
| Recipient HLA-DQ5 | 71 | 1.00 (0.61–1.64) | 0.99 | ||
| Recipient HLA-DR3 (DR17 or 18) | 80 | 1.20 (0.65–2.23) | 0.56 | ||
| Recipient HLA-DR15 | 80 | 0.99 (0.56–1.78) | 0.98 | ||
| Recipient HLA-DQ6 | 71 | 1.04 (0.62–1.75) | 0.89 | ||
| Recipient HLA-DQ2 | 71 | 1.09 (0.66–1.80) | 0.74 | ||
| Donor HLA-B35 | 80 | 1.09 (0.63–1.89) | 0.77 | ||
| Donor HLA-DQ5 | 66 | 1.24 (0.75–2.04) | 0.41 | ||
| Donor HLA-DR3 (DR17 or 18) | 80 | 1.38 (0.80–2.40) | 0.25 | ||
| Donor HLA-DR15 | 80 | 0.77 (0.44–1.36) | 0.37 | ||
| Donor HLA-DQ6 | 66 | 0.88 (0.54–1.46) | 0.63 | ||
| Donor HLA-DQ2 | 66 | 0.90 (0.53–1.53) | 0.7 | ||
| Pretransplant DSA | 76 | 1.25 (0.46–3.43) | 0.7 | ||
CUIMC, Columbia University Irving Medical center; DSA, donor-specific antibodies; OHSU, Oregon Health & Science University; HUC, Hospitais da Universidade de Coimbra; DSA, donor-specific autoantibodies; IgAN, IgA nephropathy; HLA, human leukocyte antigen.
Acute rejection is defined as any episode of acute rejection that occurred before recurrence of disease in recurrent IgAN or any time before the end of follow-up in nonrecurring controls.
Even when induction therapy with thymoglobulin was not included in the main multivariable analysis (information on induction therapy was lacking 15 patients, including 11 with recurrent IgAN), the new multivariable analysis (n = 282) revealed similarly that only younger age at transplant (0.96 [0.94–0.98], p < 0.001) and year of transplantation (1.10 [1.04–1.15], p < 0.001) remained independent predictors for IgAN but not HLA matches (1.13 [0.99–1.29], p = 0.06) or medical sites (OHSU: 1.38 [0.83–2.29], p = 0.21, HUC: 0.65 [0.29–1.45], p = 0.29).