Profiling risk for acute rejection in kidney transplantation

recipient age is a robust risk factor

Abbas Rana, Bhamidipati Murthy, Zachery Pallister, Michael Kueht, Ronald Cotton, N. Thao N. Galvan, Whiston Etheridge, Hau Liu, John Goss, Christine O’Mahony

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Careful management of immunosuppression is paramount to prevent acute rejection in kidney transplantation. We studied a cohort of 139,875 kidney transplant recipients from the Organ Procurement and Transplantation Network (OPTN) database between 2002 and 2013. We confirmed the analysis with a cohort of 35,277 who received thymoglobulin induction with tacrolimus maintenance, and a third cohort of 12,161 recipients who received basiliximab induction with tacrolimus maintenance. We performed multivariate logistic regression analyses on data from all three cohorts and identified independent risk factors for treated acute rejection at 1 year. Recipient age was a robust risk factor for rejection in all three cohorts in a dose response pattern. Young age (18–25 years) was among the strongest risk factors for rejection in all three cohorts; thymoglobulin cohort: OR 1.87 (1.59–2.19); basiliximab cohort: OR 2.41 (1.89–3.05); and inclusive cohort: OR 1.97 (1.83–2.12). The opposite was true for old age (65–69 years); thymoglobulin cohort: OR 0.69 (0.59–0.81); basiliximab cohort: OR 0.77 (0.62–0.96); and inclusive cohort: OR 0.75 (0.70–0.80). This study is unique because it is the largest and most comprehensive multivariate analysis that demonstrates recipient age is a robust risk factor for acute rejection in an inverse dose response pattern.

Original languageEnglish (US)
Pages (from-to)859-868
Number of pages10
JournalJournal of Nephrology
Volume30
Issue number6
DOIs
StatePublished - Dec 1 2017
Externally publishedYes

Fingerprint

Kidney Transplantation
Tacrolimus
Maintenance
Tissue and Organ Procurement
Organ Transplantation
Immunosuppression
Multivariate Analysis
Logistic Models
Regression Analysis
Databases
Kidney
thymoglobulin
basiliximab

Keywords

  • Acute rejection
  • Cellular rejection
  • Kidney transplantation
  • Recipient age

ASJC Scopus subject areas

  • Nephrology

Cite this

Profiling risk for acute rejection in kidney transplantation : recipient age is a robust risk factor. / Rana, Abbas; Murthy, Bhamidipati; Pallister, Zachery; Kueht, Michael; Cotton, Ronald; Galvan, N. Thao N.; Etheridge, Whiston; Liu, Hau; Goss, John; O’Mahony, Christine.

In: Journal of Nephrology, Vol. 30, No. 6, 01.12.2017, p. 859-868.

Research output: Contribution to journalArticle

Rana, A, Murthy, B, Pallister, Z, Kueht, M, Cotton, R, Galvan, NTN, Etheridge, W, Liu, H, Goss, J & O’Mahony, C 2017, 'Profiling risk for acute rejection in kidney transplantation: recipient age is a robust risk factor', Journal of Nephrology, vol. 30, no. 6, pp. 859-868. https://doi.org/10.1007/s40620-016-0354-x
Rana, Abbas ; Murthy, Bhamidipati ; Pallister, Zachery ; Kueht, Michael ; Cotton, Ronald ; Galvan, N. Thao N. ; Etheridge, Whiston ; Liu, Hau ; Goss, John ; O’Mahony, Christine. / Profiling risk for acute rejection in kidney transplantation : recipient age is a robust risk factor. In: Journal of Nephrology. 2017 ; Vol. 30, No. 6. pp. 859-868.
@article{e497e0f25e1846c3a2e46803dfaf3021,
title = "Profiling risk for acute rejection in kidney transplantation: recipient age is a robust risk factor",
abstract = "Careful management of immunosuppression is paramount to prevent acute rejection in kidney transplantation. We studied a cohort of 139,875 kidney transplant recipients from the Organ Procurement and Transplantation Network (OPTN) database between 2002 and 2013. We confirmed the analysis with a cohort of 35,277 who received thymoglobulin induction with tacrolimus maintenance, and a third cohort of 12,161 recipients who received basiliximab induction with tacrolimus maintenance. We performed multivariate logistic regression analyses on data from all three cohorts and identified independent risk factors for treated acute rejection at 1 year. Recipient age was a robust risk factor for rejection in all three cohorts in a dose response pattern. Young age (18–25 years) was among the strongest risk factors for rejection in all three cohorts; thymoglobulin cohort: OR 1.87 (1.59–2.19); basiliximab cohort: OR 2.41 (1.89–3.05); and inclusive cohort: OR 1.97 (1.83–2.12). The opposite was true for old age (65–69 years); thymoglobulin cohort: OR 0.69 (0.59–0.81); basiliximab cohort: OR 0.77 (0.62–0.96); and inclusive cohort: OR 0.75 (0.70–0.80). This study is unique because it is the largest and most comprehensive multivariate analysis that demonstrates recipient age is a robust risk factor for acute rejection in an inverse dose response pattern.",
keywords = "Acute rejection, Cellular rejection, Kidney transplantation, Recipient age",
author = "Abbas Rana and Bhamidipati Murthy and Zachery Pallister and Michael Kueht and Ronald Cotton and Galvan, {N. Thao N.} and Whiston Etheridge and Hau Liu and John Goss and Christine O’Mahony",
year = "2017",
month = "12",
day = "1",
doi = "10.1007/s40620-016-0354-x",
language = "English (US)",
volume = "30",
pages = "859--868",
journal = "Journal of Nephrology",
issn = "1121-8428",
publisher = "Wichtig Publishing",
number = "6",

}

TY - JOUR

T1 - Profiling risk for acute rejection in kidney transplantation

T2 - recipient age is a robust risk factor

AU - Rana, Abbas

AU - Murthy, Bhamidipati

AU - Pallister, Zachery

AU - Kueht, Michael

AU - Cotton, Ronald

AU - Galvan, N. Thao N.

AU - Etheridge, Whiston

AU - Liu, Hau

AU - Goss, John

AU - O’Mahony, Christine

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Careful management of immunosuppression is paramount to prevent acute rejection in kidney transplantation. We studied a cohort of 139,875 kidney transplant recipients from the Organ Procurement and Transplantation Network (OPTN) database between 2002 and 2013. We confirmed the analysis with a cohort of 35,277 who received thymoglobulin induction with tacrolimus maintenance, and a third cohort of 12,161 recipients who received basiliximab induction with tacrolimus maintenance. We performed multivariate logistic regression analyses on data from all three cohorts and identified independent risk factors for treated acute rejection at 1 year. Recipient age was a robust risk factor for rejection in all three cohorts in a dose response pattern. Young age (18–25 years) was among the strongest risk factors for rejection in all three cohorts; thymoglobulin cohort: OR 1.87 (1.59–2.19); basiliximab cohort: OR 2.41 (1.89–3.05); and inclusive cohort: OR 1.97 (1.83–2.12). The opposite was true for old age (65–69 years); thymoglobulin cohort: OR 0.69 (0.59–0.81); basiliximab cohort: OR 0.77 (0.62–0.96); and inclusive cohort: OR 0.75 (0.70–0.80). This study is unique because it is the largest and most comprehensive multivariate analysis that demonstrates recipient age is a robust risk factor for acute rejection in an inverse dose response pattern.

AB - Careful management of immunosuppression is paramount to prevent acute rejection in kidney transplantation. We studied a cohort of 139,875 kidney transplant recipients from the Organ Procurement and Transplantation Network (OPTN) database between 2002 and 2013. We confirmed the analysis with a cohort of 35,277 who received thymoglobulin induction with tacrolimus maintenance, and a third cohort of 12,161 recipients who received basiliximab induction with tacrolimus maintenance. We performed multivariate logistic regression analyses on data from all three cohorts and identified independent risk factors for treated acute rejection at 1 year. Recipient age was a robust risk factor for rejection in all three cohorts in a dose response pattern. Young age (18–25 years) was among the strongest risk factors for rejection in all three cohorts; thymoglobulin cohort: OR 1.87 (1.59–2.19); basiliximab cohort: OR 2.41 (1.89–3.05); and inclusive cohort: OR 1.97 (1.83–2.12). The opposite was true for old age (65–69 years); thymoglobulin cohort: OR 0.69 (0.59–0.81); basiliximab cohort: OR 0.77 (0.62–0.96); and inclusive cohort: OR 0.75 (0.70–0.80). This study is unique because it is the largest and most comprehensive multivariate analysis that demonstrates recipient age is a robust risk factor for acute rejection in an inverse dose response pattern.

KW - Acute rejection

KW - Cellular rejection

KW - Kidney transplantation

KW - Recipient age

UR - http://www.scopus.com/inward/record.url?scp=85035233527&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85035233527&partnerID=8YFLogxK

U2 - 10.1007/s40620-016-0354-x

DO - 10.1007/s40620-016-0354-x

M3 - Article

VL - 30

SP - 859

EP - 868

JO - Journal of Nephrology

JF - Journal of Nephrology

SN - 1121-8428

IS - 6

ER -