Baseline demographic and immunologic characteristics of study population
| Variable | Low-sensitized non-DGF (n=470) |
Low-sensitized DGF (n=109) |
Highly sensitized non-DGF (n=103) |
Highly sensitized DGF (n=27) |
|---|---|---|---|---|
| Recipient | ||||
| Age (yr) | 49.8±9.8 | 50.5±10.0 | 50.1±9.8 | 52.6±9.1 |
| Elderly (≥65 yr) | 88 (18.7) | 15 (13.8) | 22 (21.4) | 6 (22.2) |
| Male sex | 297 (63.2) |
65 (59.6) |
45 (43.7) |
12 (44.4) |
| BMI (kg/m2) | 23.1±4.8 | 22.6±4.6 | 23.0±3.5 | 23.0±3.1 |
| Dialysis vintage |
8.1±9.5 | 9.2±11.6 | 10.0±12.2 | 36.8±34.9 |
| Primary renal disease | ||||
| DM | 90 (19.1) | 18 (16.5) | 12 (11.7) | 4 (14.8) |
| HTN | 88 (18.7) | 18 (16.5) | 13 (12.6) | 2 (7.4) |
| CGN | 198 (42.1) | 52 (47.7) | 61 (59.2) | 19 (70.4) |
| Others | 94 (20.0) | 21 (19.3) | 17 (16.5) | 2 (7.4) |
| History of HTN | 374 (79.6) |
90 (82.6) |
79 (76.7) | 17 (63.0) |
| History of DM | 101 (21.5) | 25 (22.9) | 14 (13.6) | 7 (25.9) |
| Previous KT | 28 (6.0) |
10 (9.2) |
33 (32.0) |
12 (44.4) |
| Donor | ||||
| Age (yr) | 46.0±14.4 | 45.1±14.3 | 45.9±14.3 | 45.9±13.0 |
| Elderly (age≥ 65 yr) | 88 (18.7) |
10 (9.2) |
13 (12.6) | 3 (11.1) |
| Male sex | 309 (65.7) |
75 (68.8) | 78 (75.7) |
21 (77.8) |
| BMI (kg/m2) | 23.4±3.8 | 23.6±3.5 | 23.5±3.5 | 23.0±3.0 |
| HTN | 99 (21.1) | 21 (19.3) | 15 (14.6) | 3 (11.1) |
| DM | 49 (10.4) | 7 (6.4) | 7 (6.8) | 3 (11.1) |
| Cold ischemic time (hr) | 4.2±2.1 | 4.8±2.2 |
3.9±2.1 |
4.5±2.4 |
| SCD vs. ECD |
||||
| SCD | 318 (67.7) | 80 (73.4) | 78 (75.7) | 21 (77.8) |
| ECD | 152 (32.3) | 29 (26.6) | 25 (24.3) | 6 (22.2) |
| AKI by KDIGO | 240 (51.1) |
76 (69.7) |
48 (46.6) |
20 (74.1) |
| KDPI (%) | 62.8±25.9 | 62.9±22.2 | 59.0±24.5 | 63.5±23.1 |
| Immunologic parameter | ||||
| Mismatch number | ||||
| <3 | 99 (21.1) | 17 (15.6) |
18 (17.5) | 9 (33.3) |
| ≥3 | 371 (78.9) | 92 (84.4) |
85 (82.5) | 18 (66.7) |
| HLA-DSA | 7/434 (1.6) |
4/88 (4.5) |
24/100 (24.0) |
5/24 (20.8) |
| class I | 2/434 (0.5) |
0/88 (0.0) |
9/100 (9.0) |
3/24 (12.5) |
| class II | 5/434 (1.2) |
4/88 (4.5) |
18/100 (18.0) |
4/24 (16.7) |
| HLA-DSA, MFI | ||||
| 1,000 to <3,000 | 2/434 (0.5) | 4/88 (4.5) | 5/100 (5.0) | 2/24 (8.3) |
| 3,000 to <5,000 | 1/434 (0.2) | 0/88 (0.0) | 10/100 (10.0) | 0/24 (0.0) |
| 5,000 to <10,000 | 3/434 (0.7) | 0/88 (0.0) | 4/100 (4.0) | 1/24 (4.2) |
| ≥10,000 | 1/434 (0.2) | 0/88 (0.0) | 5/100 (5.0) | 2/24 (8.3) |
| Mean MFI | 3244.5 |
2401.7 |
7199.7 |
7391.4 |
| Induction therapy | ||||
| Basiliximab | 336 (71.5) |
67 (61.5) |
35 (34.0) |
12 (44.4) |
| ATG | 134 (28.5) |
42 (38.5) |
68 (66.0) |
15 (55.6) |
| Combined rituximab | 2 (0.4) |
1 (0.9) |
41 (39.8) |
7 (25.9) |
| Maintenance immunosuppression | ||||
| Tac-MMF/Myf-steroid | 468 (99.6) | 107 (98.2) | 103 (100.0) | 27 (100.0) |
| CSA-MMF/Myf-steroid | 2 (0.4) | 1 (0.9) | 0 | 0 |
| SRL-MMF/Myf-steroid | 0 | 1 (0.9) | 0 | 0 |
Values are presented as mean±standard deviation or number (%). The values for HLA-DSA were only for patients who had undergone HLA-DSA testing. In addition, the number of patients undergoing HLA-DSA test in each group was expressed in denominator.
DGF, delayed graft function; BMI, body mass index; DM, diabetes mellitus; HTN, hypertension; CGN, chronic glomerulonephritis; KT, kidney transplantation; SCD, standard criteria donors; ECD, expanded criteria donors; AKI, acute kidney injury; KDIGO, kidney disease improving global outcomes; KDPI, kidney donor profile index; HLA, human leukocyte antigen; DSA, donor-specific antibody; MFI, mean fluorescence intensity; ATG, antithymocyte globulin; Tac, tacrolimus; MMF, mycophenolate mofetil; Myf, mycophenolic acid; CSA, cyclosporine A; SRL, sirolimus.
a)P<0.05 vs. low-sensitized non-DGF; b)P<0.05 vs. low-sensitized DGF; c)P<0.05 vs. highly sensitized non-DGF; d)P<0.05 vs. highly sensitized DGF; e)For patients with a previous kidney transplant history, the years from the restart of dialysis to the date of kidney transplant was defined as the dialysis vintage; f)ECD was defined as all donors older than 60 years and donors older than 50 years with any two of the following criteria: (1) hypertension, (2) cerebrovascular cause of brain death, or (3) pre-retrieval serum creatinine level >1.5 mg/dL [20].