Table 1 Patient Characteristics. Demographic and medical details of kidney transplant patients and rejection therapy. Treatment of rejection started 5 days before and continued for up to 19 days after biopsy. SD, standard deviation; WBC, white blood cell count; RBC, red blood cell count; DoA, Day of Analysis.
Characteristic | T cell-mediated rejection (TCMR) | Antibody-mediated rejection (ABMR) | No rejection in biopsy (No RX) | Control group |
|---|---|---|---|---|
Mean age ± SD | 49 (±18) | 58 (±18) | 56 (±13) | 47 (±14) |
Female/Male | 4/10 | 1/6 | 6/12 | 10/14 |
Living donor/deceased donor transplant | 6/6, 2 unknown | 2/4, 1 unknown | 6/11, 1 unknown | 10/14 |
Primary disease | 2x IgA nephropathy, 2x diabetic nephropathy, 1x fanconi syndrome, 2x glomerulonephritis, 1x urinary reflux with megaureter, 6x unknown | 1x hypertensive nephropathy, 1x alport syndrome, 1x IgA nephropathy, 1x glomerulonephritis, 1x diabetic nephropathy, 2x unknown | 1x glomerulonephritis, 1x lupus nephritis, 4x IgA nephropathy, 1x cardiorenal syndrome, 5x diabetic nephropathy, 1x alport syndrome, 1x hypertensive nephropathy, 2x ADPKD, 2x unknown | 4x ADPKD, 2x IgA nephropathy, 2x reflux nephropathy, 1x renal cell carcinoma, 4x glomerulonephritis, 2x alport syndrome, 1x drug-induced nephritis, 2x diabetic nephropathy, 2x hypertensive nephropathy, 1x atypic hemolytic uremic syndrome, 3x unknown |
Treatment for rejection | 7x methylprednisolone, 3x anti-thymocyte globulin and methylprednisolone, 1x anti-thymocyte globulin, 1x methylprednisolone and IgG therapy, 2x no specific treatment | 1x methylprednisolone, 1x cyclophosphamide, 1x plasmapheresis and IgG therapy and anti-thymocyte globulin, 1x methylprednisolone and plasmapheresis, 3x no specific treatment | 4x methylprednisolone, 1x anti-thymocyte globulin, 13x no specific treatment | — |
Basic immuosuppression | 4x tacrolimus + mycophenolate + prednisone, 5x tacrolimus + mycophenolate + methylprednisolone, 3x tacrolimus + mycophenolate, 1x tacrolimus, 1x cyclosporine | 3x tacrolimus + mycophenolate, 1x mycophenolate + cyclosporine, 1x tacrolimus + mycophenolate + prednisone, 1x everolimus + mycophenolate + methylprednisolone, 1x tacrolimus + mycophenolate + methylprednisolone | 9x tacrolimus + mycophenolate + methylprednisolone, 4x tacrolimus + mycophenolate + prednisone, 2x tacrolimus + mycophenolate, 1x mycophenolate + cyclosporine, 1x tacrolimus + everolimus + methylprednisolone, 1x tacrolimus + azathioprine + methylprednisolone | 9x tacrolimus + mycophenolate + methylprednisolone, 9x tacrolimus + mycophenolate, 3x mycophenolate + cyclosporine, 1x everolimus + mycophenolate, 1x mycophenolate + prednisone, 1x none |
Level of steriods | 2x methylprednisolone 8 mg, 3x methylprednisolone 4 mg, 1x prednisone 125 mg, 1x prednisone 24 mg, 1x prednisone 5 mg, 1x prednisone 4 mg | 1x methylprednisolone 4 mg, 1x methylprednisolone 2 mg, 1x prednisone 2 mg | 9x methylprednisolone 4 mg, 1x methylprednisone 8 mg, 1x methylprednisolone 24 mg, 1x prednisone 2.5 mg, 1x prednisone 4 mg, 1x prednisone 7.5 mg, 1x prednisone 250 mg | 1x methylprednisolone 10 mg, 1x methylprednisolone 8 mg, 4x methylprednisolone 4 mg, 3x methylprednisolone 2 mg, 1x prednisone 5 mg |
CNI Level median (range) | 7.90 (9.74) ng/ml | 5.6 (0.7) ng/ml | 13.97 (21.6) ng/ml | 6.19 (11.86) ng/ml |
GFR median (range) DoA | 23.57 (77) ml/min/1.73 m² | 21.28 (32) ml/min/1.73 m² | 23.61 (54) ml/min/1.73 m² | 53.34 (93) ml/min/1.73 m² |
Creatinine median (range) DoA | 7.82 (44.95) mg/dl | 3.1 (2.39) mg/dl | 3.66 (10.14) mg/dl | 1.54 (3.39) mg/dl |
Urea median (range) | 95.37 (208.8) mg/dl | 133.71 (96) mg/dl | 105.33 (165) mg/dl | 57 (119) mg/dl |
Urinary protein-creatinine ratio median (range) DoA | 547.48 (1807.6) mg/g creatinine | 1357.2 (1918) mg/g creatinine | 1523.44 (4588) mg/g creatinine | 426.42 (4298) mg/g creatinine |
Urine volume ± SD | 111 (±39) ml | 120 (±50) ml | 84 (±45) ml | 76 (±34) ml |
Proteinuria median (range) | 30 (100) mg/dl | 65 (300) mg/dl | 22.5 (2000) mg/dl | 0 (100) mg/dl |
Leucocyturia median (range) | 0 (125) WBC/μl | 0 (0) WBC/μl | 0 (70) WBC/μl | 0 (70) WBC/μl |
Erythrocyturia median (range) | 200 (200) RBC/μl | 5 (200) RBC/μl | 80 (200) RBC/μl | 0 (80) RBC/μl |
Days after transplant median (range) | 66.5 (9524) | 3368 (1833) | 105 (5970) | 2067 (7349) |