Histopathological characteristics and causes of kidney graft failure in the current era of immunosuppression

Table 1 Baseline characteristics, n (%)

Baseline characteristics
Total number of graft failure	329 (100)
Female gender	127 (39)
Mean age at the time of transplant (yr)	42.2 ± 13.7
Caucasian	253 (77)
Causes of end stage renal disease:
Glomerulonephritis	99 (30)
Diabetes	71 (22)
Hypertension	35 (11)
Polycystic kidney disease	34 (10)
Congenital disorder	9 (3)
Other	81 (25)
Mean number of transplants (Range 1-3)	1.29 ± 0.59
Living donor transplant	108 (33)
Induction Immunosuppression:
Basiliximab	179 (54)
Thymoglobulin	52 (16)
Alemtuzumab	66 (20)
Other	32 (10)
Organ failure method:
Resumption of dialysis	319 (97)
Re-transplantation (preemptive re-transplant)	10 (3)
DSA within a year prior to the graft failure:
Present	184 (56)
Absent	89 (27)
Not tested	56 (17)
Mean graft survival (yr)	4.9 ± 4.4
Mean interval between biopsy and graft failure (d)	106.5 ± 104.6

DSA: Donor-specific antibodies.

Table 2 Histopathological characteristics of graft failure based on the cause of end stage renal disease, n (%)

	Glomerulonephritis (n = 99)	Diabetes (n = 71)	Hypertension (n = 35)
Acute rejection	49 (49)	21 (30)	19 (54)
Transplant glomerulopathy	14 (14)	14 (20)	4 (11)
Interstitial fibrosis and tubular atrophy	11 (11)	12 (17)	5 (14)
BK nephropathy	3 (3)	7 (10)	2 (6)
Acute tubular necrosis	1 (1)	5 (7)	3 (9)
Recurrence	6 (6)	6 (8)	1 (3)
Other	15 (15)	6 (8)	3 (9)

Table 3 Histopathological characteristics of graft failure based on the induction immunosuppressive agent, n (%)

	Depleting (127)	Non-depleting (n = 202)	P value
Acute rejection	46 (36)	86 (43)	0.25
Transplant glomerulopathy	31 (24)	96 (48)	0.003
Interstitial fibrosis and tubular atrophy	13 (10)	30 (15)	0.23
BK nephropathy	7 (6)	10 (5)	0.82
Acute tubular necrosis	6 (5)	10 (5)	0.92
Recurrence	6 (5)	8 (4)	0.74
Other	18 (14)	34 (17)	0.52