Table 1.
Baseline characteristics of donor-specific antibody (DSA) positive living donor kidney transplant recipients (DSA+) and matched immunized (PRA+) and non-immunized (PRA-) control recipients.
| Immunized | Non-immunized | ||||
|---|---|---|---|---|---|
| DSA+ | PRA+ | PRA- |
p-value
DSA+vs. PRA+ |
p-value
DSA+ vs. PRA- |
|
| N | 63 | 63 | 126 | ||
| Age recipient [median years, IQR] | 51 [34-61] | 53 [39-59] | 53 (38-62] | 0.48 | 0.31 |
| Sex recipient [females, %] | 40 [64%] | 36 [57%] | 40 [22%] | 0.47 | <0.001 |
|
BMI recipient
[median, IQR] |
24.5 [22.3-27.7] | 26.0 [22.4-30.5] | 26.3 [23.4-29.4] | 0.35 | 0.01 |
| Preemptive transplantation [n, %] | 19 [30%] | 18 [29%] | 50 [40%] | 0.85 | 0.2 |
|
Time on dialysis (days)
[median, IQR] |
309 [0-708] | 209 [0-470] | 178 [0-533] | 0.35 | 0.27 |
| Transplantations [%] | |||||
| 1st | 25 [40%] | 37 [59%] | 116 [92%] | 0.03 | <0.001 |
| 2nd | 25 [40%] | 19 [30%] | 9 [7%] | 0.26 | <0.001 |
| 3rd | 10 [16%] | 6 [10%] | 1 [1%] | 0.29 | <0.001 |
| 4th or more | 3 [5%] | 1 [2%] | 0 [0%] | 0.31 | – |
| Recipient blood group [%] | |||||
| A | 28 [44%] | 27 [43%] | 55 [44%] | 0.86 | 0.92 |
| B | 10 [16%] | 9 [14%] | 16 [13%] | 0.8 | 0.55 |
| AB | 2 [3%] | 3 [5%] | 8 [6%] | 0.65 | 0.36 |
| 0 | 23 [37%] | 24 [38%] | 47 [37%] | 0.85 | 0.92 |
| Blood group incompatible transplantation [%] | 3 [5%] | 7 [11%] | 11 [9%] | 0.19 | 0.33 |
| Primary kidney disease [%] | |||||
| Diabetic Nephropathy | 6 [10%] | 4 [6%] | 21 [17%] | 0.51 | 0.19 |
| Glomerulonephritis | 18 [29%] | 20 [32%] | 29 [23%] | 0.7 | 0.41 |
| Urological | 8 [13%] | 5 [8%] | 5 [4%] | 0.38 | 0.03 |
| Cystic kidney disease | 7 [11%] | 6 [10%] | 15 [12%] | 0.77 | 0.87 |
| Vascular | 13 [21%] | 14 [22%] | 30 [24%] | 0.82 | 0.62 |
| Hereditary | 0 [0%] | 1 [2%] | 4 [3%] | – | – |
| Other/Unknown | 11 [18%] | 13 [21%] | 22 [18%] | 0.65 | 1 |
| Age donor (years) [median, IQR] | 50 [37-59] | 48 [41-57] | 52 [40-59] | 0.69 | 0.48 |
| Sex donor [females, %] | 37 [59%] | 42 [67%] | 73 [58%] | 0.36 | 0.92 |
| Recipient-Donor Relation [%] | |||||
| Possible anti-HLA by pregnancy | 14 [22%] | 5 [8%] | 7 [6%] | 0.03 | 0.001 |
| - Child to Mother | 7 [11%] | 4 [6%] | 2 [2%] | 0.34 | 0.004 |
| - Partner to female | 7 [11%] | 1 [2%] | 5 [4%] | 0.03 | 0.06 |
| Family in Law | 4 [6%] | 1 [2%] | 10 [8%] | 0.17 | 0.69 |
| Other Related | 17 [27%] | 15 [24%] | 44 [35%] | 0.68 | 0.27 |
| Other Non-related | 28 [44%] | 42 [67%] | 65 [52%] | 0.01 | 0.35 |
| Mismatches A [%] | |||||
| 0 | 13 [21%] | 18 [29%] | 24 [20%] | 0.3 | 0.82 |
| 1 | 29 [47%] | 26 [42%] | 71 [58%] | 0.59 | 0.16 |
| 2 | 20 [32%] | 18 [29%] | 28 [23%] | 0.7 | 0.16 |
| Mismatches B [%] | |||||
| 0 | 5 [8%] | 15 [24%] | 18 [15%] | 0.02 | 0.21 |
| 1 | 27 [44%] | 28 [45%] | 54 [44%] | 0.86 | 0.96 |
| 2 | 30 [48%] | 19 [31%] | 51 [42%] | 0.04 | 0.37 |
| Mismatches DR [%] | |||||
| 0 | 8 [13%] | 23 [37%] | 23 [19%] | 0.002 | 0.32 |
| 1 | 29 [47%] | 25 [40%] | 64 [52%] | 0.47 | 0.5 |
| 2 | 25 [40%] | 14 [23%] | 36 [29%] | 0.03 | 0.13 |
| Peak PRA [%] | |||||
| Median [IQR] | 75 [35-90] | 73 [40-84] | 4 [0-4] | 1 | <0.001 |
| 1-5% | 4 [6%] | 5 [8%] | 126 [100%] | 0.71 | – |
| 6-84% | 39 [62%] | 43 [68%] | 0[0%] | 0.49 | – |
| 85-100% | 20 [32%] | 15 [24%] | 0 [0%] | 0.35 | – |
|
Transplantation Year
[median, IQR] |
2013 (2011-2014) | 2015 (2012-2017) | 2013 (2012-2015) | 0.03 | 0.41 |
| Induction therapy [%] | |||||
| No induction | 1 [2%] | 6 [10%] | 9 [7%] | 0.05 | 0.11 |
| Basiliximab | 53 [84%] | 47 [75%] | 103 [82%] | 0.19 | 0.69 |
| Rituximab | 1 [2%] | 4 [6%] | 10 [8%] | 0.17 | 0.11 |
| ATG | 4 [6%] | 2 [3%] | 3 [2%] | 0.4 | 0.17 |
| Alemtuzumab | 4 [6%] | 4 [6%] | 1 [1%] | 1 | 0.03 |
| Baseline Immunosuppression [%] | |||||
| Corticosteroids, Tacrolimus & Mycophenolic acid | 59 [94%] | 59 [94%] | 120 [95%] | 0.65 | 0.65 |
| Other | 4 [6%] | 4 [6%] | 6 [5%] | 0.65 | 0.65 |
IQR, inter-quartile range; DSA, donor specific antibodies; PRA, panel reactive antibodies; ATG, anti-thymocyte globulin.