Table 3.

Characteristics of acute rejection and histologic findings on protocol biopsy at 3 months post-transplant

VariablesValganciclovir (n=60)Valacyclovir (n=59)P Value
Biopsy-proven acute rejection10 (17)18 (31)0.03a
 Grade IA5 (8)8 (14)
 Grade IB1 (2)2 (3)
 Grade IIA3 (5)3 (5)
 Grade IIB1 (2)2 (3)
 Grade III0 (0)0 (0)
 Antibody-mediated rejectionb2 (3)3 (5)
Depleting ALA for rejection5 (8)7 (12)0.74
Protocol biopsy
 No. of patients5954
 Glomeruli per biopsy, mean±SD10.1±4.910.9±6.30.88
 Arteries per biopsy, mean±SD1.3±1.01.2±1.10.52
 Subclinical rejection2 (3)2 (4)0.68
 Borderline changes7 (12)11 (20)0.33
 IF/TA (all grades)15 (25)9 (17)0.37
 Moderate-to-severe IF/TAc3 (5)3 (6)0.76
 Chronic ci+ct score, mean±SD0.81±1.110.70±1.100.62
 Chronic antibody-mediated rejection1 (2)0 (0)0.97
 Chronic T cell-mediated rejection0 (0)1 (2)0.97
 Calcineurin inhibitor toxicity6 (10)4 (7)0.85
 Vascular nephrosclerosis21 (36)15 (28)0.49
 Polyomavirus-associated nephropathy6 (10)0 (0)0.05
  • Data are n (%) unless otherwise indicated. ALA, antilymphocyte antibody; IF/TA, interstitial fibrosis and tubular atrophy; ci, interstitial fibrosis; ct, tubular atrophy.

  • a Hazard ratio, 2.49; 95% confidence interval, 1.09 to 5.65 after adjustment for age, previous transplantation, peak panel reactive antibodies, HLA mismatches, calcineurin inhibitor, induction therapy, donor age, donor type, expanded criteria donor, and delayed graft function.

  • b Both patients with antibody-mediated rejection in the valganciclovir group suffered from concomitant acute T cell-mediated rejection.

  • c Grade II or III according to the Banff 09 classification.