Role of steroid maintenance in sensitized kidney transplant recipients

Table 1 Demographic features

	Peak-PRA 0%-30%		Peak-PRA 31%-60%		Peak-PRA > 60%
	Steroid	No steroid	Steroid	No steroid	Steroid	No steroid
	(n = 25218)	(n = 7399)	(n = 3495)	(n = 850)	(n = 4966)	(n = 923)
Donor factors
Age	38 ± 17	39 ± 17b	37 ± 17	38 ± 18	35 ± 15	35 ± 16
Gender (M/F) %	59/41	59/41	60/40	57/43	60/40	66/34b
Death from CVA (%)	42	40a	38	41a	36	35a
ECD kidney (%)	18	20d	15	22d	8	10
DCD kidney (%)	7.7	9.1d	6.1	7.6	6.7	8.1
Recipient factors
Age (yr)	51 ± 13	53 ± 13d	37 ± 17	38 ± 17	47 ± 13	49 ± 13
Gender (M/F) %	66/34	67/33	51/49	51/49	37/63	34/66
African American	30	26d	28	28	33	31
Diabetes	33	36d	29	34b	25	28
Pre-transplant dialysis (%)	91	88d	89	84d	91	91
Dialysis duration (mo)	45 ± 34	44 ± 35a	49 ± 42	47 ± 42	61 ± 51	59 ± 52
Previous transplant (%)	7.3	4.6d	21.8	14.6d	44.2	37.9d
HLA mismatches	3.7 ± 1.8	3. 7 ± 1.9	3.5 ± 2.0	3.1 ± 2.0a	3.1 ± 2.0	3.0 ± 2.0
Transplant- related factors
Cold ischemia (h)	18.1 ± 8.1	18.8 ± 8.0d	18.3 ± 7.9	20.8 ± 10.2d	18.4 ± 8.1	19.3 ± 8.2b
Delayed graft function (%)	24.4	19.5d	22.9	19.6a	26	20.8b

P value is for steroid vs no steroid:

^aP < 0.05,

^bP < 0.01;

^dP < 0.001. CVA: Cerebrovascular accident; DCD: Donation after cardiac death; ECD: Expanded criteria donor; HLA: Human leukocyte antigen; PRA: Panel reactive antibody.

Table 2 Adjusted overall and death-censored graft failure risks as well as patient death risk for chronic steroid maintenance vs early steroid withdrawal groups in patients ≥ 60 years of age

PRA class	Adjusted overall graft failure risk		Adjusted death-censored graft failure risk		Adjusted patient death risk
	HR	95%CI	HR	95%CI	HR	95%CI
0%-30%	1.28d	1.14-1.47	1.27b	1.10-1.45	1.43d	1.22-1.64
31%-60%	1.04	0.71-1.47	1.04	0.70-1.54	1.20	0.79-1.81
> 60%	0.74	0.51-1.09	0.71	0.48-1.09	0.76	0.49-1.19

^bP: 0.001, vs overall graft survivals;

^dP < 0.001, vs death-censored graft survivals. PRA: Panel reactive antibody.