Impact of pretransplant donor-specific antibodies and human leukocyte antigen mismatches on graft and patient outcomes: A cohort from Saudi Arabia

Table 2 Univariate comparison between donor-specific antibody-positive and donor-specific antibody-negative kidney transplant recipients, n (%)/median (interquartile range)

Group and variable	DSA-negative	DSA-positive	Univariate
Recipient
Age	38.0 [29.0-58.0]	47.0 [35.0-61.0]	0.0121
Gender			0.8942
Male	66 (60.6)	89 (58.9)
Female	43 (39.4)	62 (41.1)
Donor
Age	33.0 [28.0-42.0]	34.0 [28.0-41.0]	0.7858
Gender			0.7613
Male	73 (67.0)	105 (69.5)
Female	36 (33.0)	46 (30.5)
Type			0.3038
Living donor	97 (89.0)	141 (93.4)
Deceased donor	12 (11.0)	10 (6.6)
DSA & HLA matching
HLA mismatches	5.0 [2.0-7.0]	7.0 [5.0-9.0]	0.0000
DSA strength			-
< 1000 MFI	-	71 (47.0)
≥ 1000 MFI	-	80 (53.0)
DSA type	-		-
Class I only	-	30 (19.9)
Class II only	-	52 (34.4)
Both	-	69 (45.7)
Number of DSAs		3.0 [1.0-6.0]	-
Cumulative MFI		2145.0 [895.5-4235.0]	-
Treatment & sensitization
ATG dose	4.0 [4.0-5.0]	5.0 [4.0-5.0]	0.1388
Sensitizing events			1.0000
Yes	7 (6.4)	10 (6.6)
No	102 (93.6)	141(93.4)
Induction therapy			0.0000
ATG-based	69 (63.3)	145 (96.0)
Basiliximab-based	37 (33.9)	6 (4.0)
Mixed	3 (2.8)	0 (0.0)
Maintenance therapy			1.0000
FK MMF Pred	107(98.2)	149 (98.7)
CSA MMF Pred	2 (1.8)	2 (1.3)
Diabetes pre-transplant			0.1624
Yes	40 (36.7)	69 (45.7)
No	69 (63.3)	82 (54.3)
Use of IVIG			0.0000
Yes	0 (0)	94 (57.6)
No	96 (100)	69 (42.3)
Previous transplant			0.1429
Yes	0 (0.0)	4 (2.6)
No	108 (100.0)	147 (97.4)
Graft function & outcomes
Acute rejection			0.5274
Yes	3 (2.8)	7 (4.6)
No	106 (97.2)	144 (95.4)
Graft loss			0.0796
Yes	2 (1.8)	10 (6.6)
No	10 (98.2)	141 (93.4)
Delayed graft function			1.0000
Yes	5 (4.6)	7 (4.6)
No	104 (95.4)	144 (95.4)
Death (mortality)			0.1442
Yes	1 (0.9)	7 (4.6)
No	108 (99.1)	144 (95.4)
CMV infection			1.0000
Yes	2 (1.8)	3 (2.0)
No	107 (98.2)	148 (98.0)
BKV infection			0.4066
Yes	1 (1.0)	4 (2.9)
No	98 (99.0)	136 (97.1)
Length of stay (days)	9.0 [8.0-12.0]	9.0 [7.0-12.0]	0.9488
Creatinine - 4 months	91.0 [74.0-110.0]	93.5 [73.2-114.0]	0.8153
Creatinine - 1 year	93.0 [73.5-111.5]	89.0 [73.0-109.0]	0.7218
Creatinine - 2 years	94.0 [72.0-103.0]	88.0 [71.0-110.0]	0.7605
eGFR - 4 months	83.0 [65.0-95.0]	77.5 [64.0-92.5]	0.2258
eGFR - 1 year	83.0 [67.0-97.0]	82.5 [65.0-99.0]	0.8518
eGFR - 2 years	83.0 [72.5-95.8]	86.0 [71.0-97.0]	0.9898

Statistical comparisons were conducted using the Mann-Whitney U test for continuous variables and χ² or Fisher’s exact test for categorical variables, depending on expected cell counts. A P value < 0.05 was considered statistically significant. Analyses were performed using listwise deletion to account for missing data. DSA: Donor-specific antibody; MFI: Mean fluorescence intensity; HLA: Human leukocyte antigen; ATG: Antithymocyte globulin; FK: Tacrolimus; MMF: Mycophenolate mofetil; Pred: Prednisolone; CSA: Cyclosporine; IVIG: Intravenous immunoglobulin; CMV: Cytomegalovirus; BKV: BK virus; eGFR: Estimated glomerular filtration rate.