Induction with anti-T-lymphocyte globulins and human immunoglobulins: A strategy for hyperimmunized liver transplant patients

Table 2 Immunological status of the recipient and donor at the time of transplantation, n (%)/mean ± SD

	High-risk group (n = 46)	Low-risk group (n = 46)	P value
T-lymphocytes D/R CM			< 0.01a
Negative	9 (19.6)	46 (100.0)
Positive	37 (80.4)	0 (0.0)
Recipient HLA antibodies class I			< 0.01a
Negative	7 (15.2)	41 (89.1)
Positive	37 (80.4)	5 (10.9)
Missing data	2 (4.3)	0 (0)
Recipient HLA antibodies class II			< 0.01a
Negative	6 (13.0)	42 (91.3)
Positive	38 (82.6)	4 (8.7)
Missing data	2 (4.3)	0 (2.2)
DSA class I at transplant (MFI)			< 0.01a
Absent	9 (19.6)	42 (91.3)
< 5000	13 (28.3)	4 (8.7)
5000-10000	4 (8.7)	0 (0.0)
≥ 10000	15 (32.6)	0 (0.0)
Missing data	5 (10.8)	0 (0.0)
DSA class II at transplant (MFI)			< 0.01a
Absent	8 (17.4)	41 (89.1)
< 5000	14 (30.4)	5 (8.9)
5000-10000	3 (6.5)	0 (0.0)
≥ 10000	16 (34.8)	0 (0.0)
Missing data	5 (10.9)	0 (0.0)
Induction			< 0.01a
ATLG	46 (100)	0 (0.0)
Basiliximab	0 (0)	3 (6.5)
IVIG	43 (93.5)	0 (0.0)	< 0.01a
Immunosuppression at baseline			< 0.01a
MMF + corticosteroids (delayed introduction of CNI between day 2-3)	32 (69.6)	10 (28.3)
MMF + corticosteroids+ CNI at day 0-1	14 (30.4)	33 (71.7)
Trough level of CNI (tacrolimus) (ng/mL)
At 3 months	7.9 ± 3.3	10.7 ± 4.4	0.002
At 6 months	7.1 ± 2.1	7.1 ± 2.9	0.99
At 1 year	6.7 ± 3.3	7.2 ± 2.1	0.38
At 3 years	6.0 ± 2.7	6.3 ± 1.8	0.56
At 5 years	5.7 ± 1.9	6.0 ± 2.5	0.58
Trough level of everolimus (ng/mL)
At 1 year	4.5 ± 3.0	4.9 ± 1.6	0.62
At 3 years	5.7 ± 1.9	6.1 ± 2.5	0.59

^aP value at 0.01.

High SD is due to presence of outliers. ATLG: Anti T-lymphocyte globulins; CM: Crossmatch; CNI: Calcineurin inhibitors; D: Donor; DSA: Donor specific antibody; IVIG: Intravenous immunoglobulin; MFI: Mean fluorescence intensity; MMF: Mycophenolic acid; R: Recipient; HLA: Human leukocyte antigen.