Pretransplant Donor-Specific Anti-HLA Antibodies and the Risk for Rejection-Related Graft Failure of Kidney Allografts

Table 1

Clinical characteristics of recipients and kidney donors stratified for pretransplant donor-specific antibodies to HLA.

	DSAneg, N = 574	DSApos, N = 160	value
Age recipient ± SEM	46.2 ± 0.6	43.8 ± 1.0	0.064
Age donor ± SEM	47.2 ± 0.6	45.7 ± 1.1	0.19
Donor male sex	67.2%	40.6%	<0.001
Recipient male sex	43.7%	57.5%	0.002
Deceased donor	44.1%	58.8%	0.001
Living donor: related/unrelated	36.9%/19.0%	30.6%/10.6%	0.09
Cold ischaemia time in hours	10.2 ± 0.4	13.8 ± 0.9	0.2
Retransplantation	9.1%	49.7%	<0.001
PRA historic ± SEM	11.2% ± 0.8	43.3% ± 2.8	<0.001
PRA current ± SEM	2.9% ± 0.4	26.2% ± 2.5	<0.001
Total HLA mismatches (median)	3	3	0.4
DSA HLA class I only	—	35%
DSA HLA class II only	—	42.5%
DSA HLA class I and II	—	22.5%
Induction therapy yes/no	35/539	17/143	0.055
Anti-IL-2 receptor antibody	33	17	0.047
T cell depleting antibody	2	0	>0.99
Initial immune suppression
Steroids	93.0%	86.3%	>0.99
Tacrolimus/ciclosporin	60.3%/38.6%	59.3%/37.5%	>0.99
MMF/azathioprine	69.7%/0.5%	75.6%/0.0%	>0.99
Sirolimus	8.4%	7.5%	>0.99
Others	4.5%	3.1%	>0.99
Follow-up time (median years)	11.6	11.2	0.13
Total number of graft loss	288	95	0.040
Death with functioning graft	117	24	0.14
Surgery-related graft loss	3	0	>0.99
Cases with diagnostic renal biopsy^1	134 (78.4%)	61 (85.9%)	0.21

PRA: panel reactive antibodies; DSA: donor-specific antibodies. ¹% of total number of graft losses excluding cases of death with functioning graft.