Formation of de novo donor-specific antibodies (dnDSA) against human leukocyte antigens (HLA) contributes to inferior kidney transplant (KT) outcomes. No data exist on healthcare resource utilization (HCRU) of patients developing dnDSA post-transplant. We assessed the effect of DSA on inpatient/outpatient HCRU in the largest single-center KT cohort to date.

Demographic, graft and patient data were collected for all adult KT patients (2007–2015). DSA was assessed at transplant (time 0), 3 and 6 months, 1 and 2 years, and for cause. Patient groups: no dnDSA, dnDSA, and DSA at KT. HCRU, including number of biopsies/emergency department (ED) and inpatient/outpatient visits were abstracted from the Northwestern Medicine Enterprise Data Warehouse.

1517 KT patients [mean age (standard deviation): 49.5 years (13.2), 63.1% male] were followed for ≤8 years (mean 4.4). Patient demographics: Figure 1.Poisson regression by HLA class/locus showed number of biopsies, ED encounters and inpatient/outpatient visits were significantly greater in patients with dnDSA or DSA at KT vs no dnDSA. Median counts with no dnDSA, dnDSA, and DSA at KT (all classes/loci): biopsies 1, 2 and 1; ED visits 0, 1 and 1; hospitalization 3, 5 and 4; outpatient visits 32, 42 and 47 (p<0.001) (Figure 2).Irrespective of clinical presentation, presence of DSA at KT or development of dnDSA predisposes to increased HCRU following KT. This is noteworthy for inpatient/outpatient visits but does not differ based on HLA class/locus. Minimizing DSA formation has implications for those managing transplant patients.

CITATION INFORMATION: Ho B, Bhagat H, Lee E, Atiemo K, Daud A, Kang R, Montag S, Zhao L, Schwartz J, Ladner D. Healthcare Resource Utilization for Patients with Donor-Specific Antibodies Post-Kidney Transplantation. Am J Transplant. 2017;17 (suppl 3).

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