Kidney transplantation is a viable treatment for select patients with HIV

Kidney transplantation is a viable treatment for select patients with HIV and ESRD but data are lacking regarding long-term outcomes and comparisons with appropriately matched HIV-negative patients. graft survival (GS) (hazard ratio [HR] 1.37 95 confidence interval [95% CI] 1.15 to 1 1.64; assessments or Wilcoxon rank-sum assessments (on the basis of distribution) and categorical variables were examined Amyloid b-Peptide (1-43) (human) using chi-squared or Fisher’s exact tests of independence (on the basis of sample size). Survival Analyses DCGS GS and PS were estimated among HIV+ recipients using Kaplan-Meier methods log-rank assessments and Cox proportional hazards models. Risk factors for graft loss and patient death within the HIV+ cohort were identified using univariate Cox proportional hazards with statistical significance set at 0.1. The proportional hazards assumption was assessed and verified using time-dependent variables. DCGS GS and PS among HIV+ recipients were compared with the general unmatched HIV? populace and to appropriately matched HIV? controls using Kaplan-Meier methods log-rank assessments and Cox proportional hazards models. HIV+ recipients were matched to appropriate HIV? counterfactuals 1:10 using iterative expanded radius matching without replacement and Amyloid b-Peptide (1-43) (human) were matched on factors found to be significantly associated with each outcome. The matching algorithm for GS included recipient age and race HCV contamination CNI-based maintenance immunosuppression PRA CIT (for deceased donors only) and transplant 12 months. The matching algorithm for PS included HCV contamination CNI-based maintenance recipient age and race and transplant 12 months. Additional covariates Amyloid b-Peptide (1-43) (human) were adjusted for as part of sensitivity analyses and inferences did not change. For simplicity results from the matched analyses without additional adjustment are reported. Sensitivity Amyloid b-Peptide (1-43) (human) Analyses Covariates decided to be significant on exploratory analyses (Table 1) were used to build full multivariate models. Results from these models confirmed inferences reported from the matched (1:10) analyses. Matched control analyses must balance introduction of bias with reduction in variability (i.e. with increasing numbers of controls per patient more bias is usually potentially introduced; however variability is usually theoretically reduced). Given this the analyses were performed among four distinct matched cohorts (1:1 1 1 and 1:10); inferences did not change. For Amyloid b-Peptide (1-43) (human) the purposes of simplicity results comparing outcomes among HIV+ and HIV? kidney transplant recipients are from the 1:10 matched cohort. Finally multivariate models adjusting for additional covariates were built in the 1:10 matched cohort: 1) GS and DCGS models adjusted for recipient age race sex BMI ATG induction maintenance steroids and donor age; and 2) Mouse monoclonal to CDC2 PS model adjusted for recipient sex BMI PRA ATG induction maintenance steroids and donor age and CIT; inferences did not change. Disclosures None Acknowledgments This research was supported in part by the NIH (no. K24-DK101828) (principal investigator: Segev). This research was presented in preliminary forms as abstracts at the 2014 American Society of Transplant Surgeons State of the Art Winter Symposium and the 2014 World Transplant Congress. These analyses were performed by the University of Alabama at Birmingham’s Comprehensive Transplant Institute Outcomes Research Center analytic team. The data reported here have been supplied by the Minneapolis Medical Research Foundation as the contractor for the SRTR. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy of or interpretation by the SRTR or the US Government. Footnotes Published online ahead of print. Publication date available at See related editorial “Kidney Transplantation in HIV-Infected Recipients: Encouraging Outcomes but Registry Data Are No Longer Enough ” on pages.