Table S1 – Demographics by recipient sex
Total
N Recipient Sex
Male Female p-Value
Donor Age (Years) 25140 50 (38 - 59) 49 (37 - 59) 0.020
Donor Sex (Male) 25140 8403 (53.6%) 5011 (53.0%) 0.418
Donor BMI 24449 25.6 (22.9 - 28.7) 25.4 (22.9 - 28.7) 0.077
Donor Ethnicity 25099 0.214
White 15084 (96.3%) 9052 (96.0%)
Asian 264 (1.7%) 182 (1.9%)
Black 162 (1.0%) 86 (0.9%)
Mixed/Other 158 (1.0%) 111 (1.2%)
Donor Terminal Creatinine 23382 75 (59 - 97) 75 (59 - 98) 0.701
Donor Cause of Death 25140 0.063
Intracranial haemorrhage 9845 (62.7%) 5978 (63.3%)
Hypoxic brain damage 2624 (16.7%) 1563 (16.5%)
Trauma 1752 (11.2%) 1109 (11.7%)
Other 1469 (9.4%) 800 (8.5%)
Donor Type (DBD) 25140 11181 (71.3%) 7105 (75.2%) <0.001 Donor History of Diabetes 24485 823 (5.4%) 454 (4.9%) 0.123 Donor History of Hypertension 24238 3650 (24.2%) 2117 (23.2%) 0.084 Donor Smoking History 24414 7364 (48.4%) 4395 (47.8%) 0.376
Donor HCV (Positive) 25053 21 (0.1%) 9 (0.1%) 0.451
Donor CMV (Positive) 24833 7668 (49.5%) 4561 (48.9%) 0.359 Donor Risk Index 23371 1.04 (0.96 - 1.44) 1.04 (0.96 - 1.43) 0.229 Recipient Age (Years) 25139 50 (38 - 59) 49 (37 - 59) <0.001 Recipient BMI 14402 25.9 (23.0 - 29.3) 25.3 (21.8 - 29.2) <0.001
Recipient Ethnicity 24934 0.007
White 12290 (79.0%) 7258 (77.5%)
Asian 2050 (13.2%) 1379 (14.7%)
Black 1004 (6.4%) 605 (6.5%)
Mixed/Other 222 (1.4%) 126 (1.3%)
Recipient Diabetes 25140 1276 (8.1%) 569 (6.0%) <0.001
Recipient HCV (Positive) 18823 80 (0.7%) 52 (0.7%) 0.721
Recipient CMV (Positive) 22424 6828 (48.6%) 4695 (56.0%) <0.001 Recipient Waiting Time (Days) 25116 718 (292 - 1299) 811 (323 - 1458) <0.001
Recipient Dialysis at Transplant 22506 <0.001
Haemodialysis 10028 (71.2%) 5435 (64.5%)
Peritoneal Dialysis 4025 (28.6%) 2973 (35.3%)
Not on Dialysis 26 (0.2%) 19 (0.2%)
Transplant Year 25140 0.050*
2000 - 2004 4014 (25.6%) 2471 (26.1%)
2005 - 2009 3906 (24.9%) 2482 (26.3%)
2010 - 2013 4139 (26.4%) 2338 (24.7%)
2014 - 2016 3631 (23.1%) 2159 (22.8%)
CIT (Mins) 24834 954 (758 - 1174) 963 (780 - 1174) 0.002
Mismatch Level 25138 <0.001*
1 2042 (13.0%) 1535 (16.2%)
2 6023 (38.4%) 3687 (39.0%)
3 6502 (41.4%) 3689 (39.0%)
4 1122 (7.2%) 538 (5.7%)
AITX 25140 <0.001*
No 15588 (99.3%) 9338 (98.8%)
HLAi 99 (0.6%) 111 (1.2%)
ABOi 3 (0.0%) 1 (0.0%)
CRF at Transplant 25139 <0.001*
0% 11446 (73.0%) 5234 (55.4%)
1-85% 3309 (21.1%) 3023 (32.0%)
>85% 934 (6.0%) 1193 (12.6%)
Continuous factors are reported as medians and interquartile ranges, with p-values from Mann-Whitney tests.
Categorical factors are reported as N (%), with p-values from Fisher’s exact test for those with two categories, or Chi-square tests where there are more categories, unless stated otherwise. Bold p-values are significant at p<0.05. *p-Value from Mann-Whitney test, as the factor is ordinal.
Table S2 – Multivariable analysis of DGF/PNF
Male Recipient Female Recipient
OR (95% CI) p-Value OR (95% CI) p-Value
Donor Sex (Female) 0.89 (0.80 - 0.98) 0.019 0.81 (0.71 - 0.93) 0.003
Donor Age (Years) 0.002 0.061
<40 - - - -
40-49 1.74 (1.20 - 2.53) 0.003 1.73 (1.08 - 2.78) 0.024
50-59 1.94 (1.34 - 2.80) <0.001 1.86 (1.16 - 2.99) 0.010
60+ 2.18 (1.41 - 3.37) <0.001 1.66 (0.96 - 2.87) 0.072
Donor BMI <0.001 - NS
<18.5 0.96 (0.67 - 1.38) 0.829 - -
18.5-24.9 - - - -
25.0-29.9 1.13 (1.01 - 1.26) 0.029 - -
30.0+ 1.32 (1.15 - 1.51) <0.001 - -
Donor Terminal Creatinine <0.001 <0.001
<60 - - - -
60-74 1.12 (0.98 - 1.28) 0.103 1.08 (0.90 - 1.30) 0.425
75-99 1.19 (1.04 - 1.36) 0.010 1.04 (0.86 - 1.25) 0.694
100+ 1.84 (1.60 - 2.12) <0.001 1.51 (1.24 - 1.82) <0.001
Donor Cause of Death 0.024 0.002
Intracranial haemorrhage - - - -
Hypoxic brain damage 1.05 (0.92 - 1.20) 0.440 1.02 (0.85 - 1.22) 0.827
Trauma 0.91 (0.76 - 1.08) 0.265 0.63 (0.49 - 0.80) <0.001
Other 1.24 (1.06 - 1.46) 0.009 0.92 (0.73 - 1.17) 0.499
Donor Type (DCD) 3.10 (2.76 - 3.49) <0.001 3.25 (2.75 - 3.84) <0.001 Donor History of Hypertension 1.15 (1.01 - 1.32) 0.039 1.18 (0.99 - 1.42) 0.072
Donor Risk Index 0.066 0.057
<0.95 - - - -
0.95-1.04 0.79 (0.54 - 1.14) 0.202 0.88 (0.55 - 1.42) 0.605
1.05-1.49 0.87 (0.58 - 1.30) 0.494 1.09 (0.66 - 1.80) 0.738
1.50+ 1.10 (0.67 - 1.78) 0.711 1.47 (0.80 - 2.68) 0.214
Recipient Ethnicity <0.001 0.003
White - - - -
Asian 1.05 (0.92 - 1.20) 0.448 1.03 (0.86 - 1.23) 0.764
Black 1.45 (1.23 - 1.72) <0.001 1.44 (1.16 - 1.80) 0.001
Other 0.94 (0.65 - 1.36) 0.727 0.62 (0.35 - 1.08) 0.089
Recipient Diabetes 1.16 (0.99 - 1.36) 0.068 1.39 (1.08 - 1.80) 0.012 Recipient Waiting Time
(Months) <0.001 0.023
<12 - - - -
12-23 1.12 (0.97 - 1.29) 0.112 1.17 (0.95 - 1.45) 0.136
24-47 1.32 (1.16 - 1.50) <0.001 1.31 (1.09 - 1.59) 0.004
48+ 1.46 (1.26 - 1.69) <0.001 1.33 (1.08 - 1.63) 0.007
CIT (Hours) 0.006 - NS
<12 - - - -
12-15 1.13 (0.99 - 1.29) 0.065 - -
16-19 1.23 (1.07 - 1.42) 0.004 - -
20+ 1.28 (1.10 - 1.48) 0.001 - -
Recipient Dialysis at Transplant <0.001 <0.001
Haemodialysis - - - -
Peritoneal Dialysis 0.49 (0.44 - 0.55) <0.001 0.48 (0.42 - 0.55) <0.001 Not on Dialysis 0.50 (0.16 - 1.53) 0.225 0.14 (0.02 - 1.09) 0.061
Transplant Year <0.001 <0.001
2000 - 2004 - - - -
2005 - 2009 0.80 (0.69 - 0.93) 0.004 0.61 (0.51 - 0.74) <0.001
2010 - 2013 0.62 (0.53 - 0.73) <0.001 0.40 (0.33 - 0.49) <0.001 2014 - 2016 0.48 (0.40 - 0.56) <0.001 0.30 (0.24 - 0.38) <0.001
Mismatch Level 0.054 0.005
1 - - - -
2 1.13 (0.97 - 1.33) 0.119 1.24 (1.00 - 1.52) 0.046
3 1.02 (0.86 - 1.20) 0.856 1.45 (1.17 - 1.80) <0.001
4 1.22 (0.97 - 1.54) 0.086 1.47 (1.06 - 2.05) 0.022
AITx or ABOi 1.81 (1.13 - 2.88) 0.013 1.80 (1.11 - 2.90) 0.017
CRF at Transplant <0.001 <0.001
0 - - - -
1-85% 1.08 (0.96 - 1.21) 0.192 1.19 (1.03 - 1.37) 0.016
>85% 1.44 (1.19 - 1.74) <0.001 1.58 (1.29 - 1.94) <0.001 Results are from multivariable binary logistic regression models, with a composite outcome of DGF/PNF as the dependent variable. All factors in Table 1 with >90% data completeness were considered for inclusion in the models, with variable selection using a backwards stepwise approach. The final models were based on N=9475 (3209 outcomes) and N=5543 (1591 outcomes) for male and female recipients, respectively, after exclusions for missing data. Bold p-values are significant at p<0.05. NS=Not selected for inclusion in the final model by the stepwise procedure.
Table S3 – Multivariable analysis of patient survival
Male Recipient Female Recipient
HR (95% CI) p-Value HR (95% CI) p-Value
Donor Sex (Female) 0.94 (0.87 - 1.03) 0.174 1.06 (0.95 - 1.19) 0.302
Donor Age (Years) <0.001 <0.001
<40 - - - -
40-49 1.20 (1.05 - 1.37) 0.008 1.03 (0.86 - 1.24) 0.765
50-59 1.30 (1.15 - 1.48) <0.001 1.30 (1.10 - 1.54) 0.002
60-69 1.52 (1.33 - 1.74) <0.001 1.35 (1.12 - 1.61) 0.001
Donor Type (DCD) - NS 1.11 (0.95 - 1.30) 0.182
Donor History of Diabetes - NS 1.15 (0.89 - 1.48) 0.288
Donor History of Hypertension 1.16 (1.05 - 1.28) 0.002 1.22 (1.07 - 1.40) 0.004
Donor HCV 2.09 (1.00 - 4.41) 0.052 7.48 (1.85 - 30.2) 0.005
Recipient Age <0.001 <0.001
<40 - - - -
40-49 2.04 (1.71 - 2.43) <0.001 1.82 (1.45 - 2.29) <0.001
50-59 3.62 (3.09 - 4.24) <0.001 3.49 (2.83 - 4.30) <0.001
60-69 7.80 (6.68 - 9.12) <0.001 6.40 (5.19 - 7.88) <0.001
Recipient Diabetes 1.81 (1.60 - 2.05) <0.001 2.16 (1.80 - 2.61) <0.001
Recipient Waiting Time (Months) 0.008 0.005
<12 - - - -
12-23 1.02 (0.91 - 1.15) 0.745 1.18 (1.00 - 1.40) 0.053
24-47 1.01 (0.90 - 1.13) 0.867 0.93 (0.79 - 1.09) 0.356
48+ 1.22 (1.07 - 1.38) 0.002 1.18 (1.00 - 1.40) 0.052
CIT (Hours) 0.201 0.089
<12 - - - -
12-15 0.94 (0.82 - 1.09) 0.416 1.15 (0.93 - 1.43) 0.203
16-19 0.99 (0.85 - 1.14) 0.863 1.05 (0.85 - 1.31) 0.636
20+ 1.06 (0.92 - 1.23) 0.415 1.24 (1.00 - 1.55) 0.055
Dialysis at Transplant <0.001 <0.001
Haemodialysis - - - -
Peritoneal Dialysis 0.80 (0.73 - 0.87) <0.001 0.76 (0.67 - 0.86) <0.001
Not on Dialysis 0.27 (0.04 - 1.96) 0.197 1.61 (0.51 - 5.06) 0.412
Transplant Year <0.001 0.001
2000 - 2004 - - - -
2005 - 2009 0.76 (0.68 - 0.85) <0.001 0.79 (0.68 - 0.92) 0.003
2010 - 2013 0.75 (0.65 - 0.86) <0.001 0.77 (0.63 - 0.94) 0.012
2014 - 2016 0.59 (0.48 - 0.73) <0.001 0.61 (0.45 - 0.81) <0.001
AITx or ABOi - NS 2.27 (1.33 - 3.87) 0.003
Results are from multivariable Cox regression models. All factors in Table 1 with >90% data completeness were considered for inclusion in the models, with variable selection using a backwards stepwise approach. The final models were based on N=11243 (2234 deaths) and N=6747 (1187 deaths) for male and female recipients, respectively, after exclusions for missing data. Bold p-values are significant at p<0.05. NS=Not selected for inclusion in the final model by the stepwise procedure.
Table S4 – Multivariable analysis of graft survival
Male Recipient Female Recipient
HR (95% CI) p-Value HR (95% CI) p-Value
Donor Sex (Female) 1.01 (0.93 - 1.09) 0.816 1.03 (0.92 - 1.14) 0.633
Donor Age (Years) <0.001 <0.001
<40 - - - -
40-49 1.32 (1.17 - 1.48) <0.001 1.36 (1.17 - 1.58) <0.001 50-59 1.48 (1.32 - 1.66) <0.001 1.61 (1.39 - 1.87) <0.001 60-69 2.12 (1.87 - 2.40) <0.001 2.40 (2.04 - 2.81) <0.001
Donor Ethnicity 0.018 0.088
White - - - -
Asian 1.42 (1.08 - 1.86) 0.011 1.42 (1.02 - 1.98) 0.038
Black 1.40 (1.00 - 1.97) 0.049 1.42 (0.88 - 2.31) 0.153
Other 1.05 (0.70 - 1.59) 0.815 1.18 (0.73 - 1.90) 0.507
Donor Terminal
Creatinine - NS 0.040
<60 - - - -
60-74 - - 1.13 (0.97 - 1.31) 0.115
75-99 - - 1.02 (0.87 - 1.18) 0.817
100+ - - 1.20 (1.02 - 1.40) 0.026
Donor Cause of Death - NS 0.074
Intracranial
haemorrhage - - - -
Hypoxic brain
damage - - 0.79 (0.66 - 0.94) 0.009
Trauma - - 0.94 (0.79 - 1.10) 0.419
Other - - 0.95 (0.79 - 1.14) 0.581
Donor Type (DCD) - NS 1.12 (0.96 - 1.30) 0.155
Donor History of
Diabetes 1.28 (1.08 - 1.51) 0.004 1.20 (0.96 - 1.51) 0.108
Donor History of
Hypertension 1.18 (1.07 - 1.29) <0.001 1.14 (1.01 - 1.28) 0.035
Donor Smoking History 1.07 (0.99 - 1.16) 0.074 - NS
Recipient Age <0.001 <0.001
<40 - - - -
40-49 0.73 (0.66 - 0.82) <0.001 0.61 (0.54 - 0.70) <0.001 50-59 0.70 (0.62 - 0.78) <0.001 0.53 (0.46 - 0.61) <0.001 60-69 0.75 (0.67 - 0.85) <0.001 0.55 (0.47 - 0.64) <0.001
Recipient Ethnicity <0.001 - NS
White - - - -
Asian 0.98 (0.86 - 1.11) 0.718 - -
Black 1.40 (1.20 - 1.62) <0.001 - -
Other 0.97 (0.70 - 1.36) 0.879 - -
Recipient Diabetes 1.12 (0.96 - 1.29) 0.146 1.46 (1.21 - 1.77) <0.001
CIT (Hours) 0.043 0.010
<12 - - - -
12-15 1.11 (0.97 - 1.28) 0.123 1.17 (0.97 - 1.41) 0.104
16-19 1.13 (0.98 - 1.30) 0.082 1.18 (0.98 - 1.43) 0.085
20+ 1.22 (1.06 - 1.41) 0.006 1.35 (1.12 - 1.64) 0.002
Recipient Dialysis at
Transplant <0.001 0.002
Haemodialysis - - - -
Peritoneal Dialysis 0.84 (0.77 - 0.92) <0.001 0.83 (0.75 - 0.93) <0.001 Not on Dialysis 0.47 (0.12 - 1.90) 0.292 0.35 (0.05 - 2.51) 0.297
Transplant Year <0.001 <0.001
2000 - 2004 - - - -
2005 - 2009 0.77 (0.70 - 0.85) <0.001 0.84 (0.74 - 0.95) 0.006 2010 - 2013 0.71 (0.63 - 0.80) <0.001 0.71 (0.60 - 0.83) <0.001 2014 - 2016 0.68 (0.58 - 0.80) <0.001 0.67 (0.54 - 0.83) <0.001
Mismatch Level <0.001 0.002
1 - - - -
2 1.12 (0.98 - 1.27) 0.089 1.16 (1.00 - 1.34) 0.052
3 1.28 (1.12 - 1.46) <0.001 1.20 (1.03 - 1.41) 0.019
4 1.38 (1.15 - 1.65) <0.001 1.57 (1.25 - 1.98) <0.001
AITx or ABOi 1.62 (1.08 - 2.42) 0.019 - NS
CRF at Transplant <0.001 <0.001
0% - - - -
1-85% 1.06 (0.96 - 1.17) 0.247 1.15 (1.03 - 1.29) 0.010
>85% 1.45 (1.23 - 1.70) <0.001 1.46 (1.24 - 1.71) <0.001 Results are from multivariable Cox regression models. All factors in Table 1 with >90% data completeness were considered for inclusion in the models, with variable selection using a backwards stepwise approach. The final models were based on N=13036 (2613 outcomes) and N=7498 (1621 outcomes) for male and female recipients, respectively, after exclusions for missing data. Bold p-values are significant at p<0.05. NS=Not selected for inclusion in the final model by the stepwise procedure.
Table S5 – Multivariable analysis of one year creatinine
Male Recipient Female Recipient
Coefficient (95% CI) p-Value Coefficient (95% CI) p-Value
Donor Sex (Female) 6.3% (4.8%, 7.7%) <0.001 4.1% (2.1%, 6.1%) <0.001
Donor Age (Years) <0.001 <0.001
<40 - - - -
40-49 12.7% (10.6%, 14.8%) <0.001 15.6% (12.6%, 18.7%) <0.001 50-59 25.4% (23.1%, 27.7%) <0.001 27.2% (23.8%, 30.6%) <0.001
60+ 44.0% (41.1%, 47.0%) <0.001 45.6% (41.3%, 50.0%) <0.001
Donor Ethnicity <0.001 NS
White - - - -
Asian 9.7% (4.6%, 15.1%) <0.001 - -
Black 4.7% (-1.6%, 11.3%) 0.148 - -
Other -0.2% (-6.3%, 6.3%) 0.950 - -
Donor Terminal Creatinine <0.001 <0.001
<60 - - - -
60-74 2.7% (0.8%, 4.5%) 0.004 2.3% (-0.4%, 5.0%) 0.091
75-99 4.3% (2.4%, 6.2%) <0.001 4.7% (2.0%, 7.5%) <0.001
100+ 8.5% (6.5%, 10.7%) <0.001 9.5% (6.5%, 12.6%) <0.001
Donor Cause of Death <0.001 <0.001
Intracranial haemorrhage - - - -
Hypoxic brain damage -3.0% (-4.8%, -1.2%) 0.001 -4.5% (-7.1%, -1.9%) <0.001 Trauma -5.5% (-7.6%, -3.4%) <0.001 -4.4% (-7.4%, -1.3%) 0.005
Other 0.8% (-1.5%, 3.1%) 0.498 1.4% (-2.0%, 4.9%) 0.417
Donor Type (DCD) 8.6% (6.8%, 10.3%) <0.001 9.6% (6.9%, 12.3%) <0.001 Donor History of Diabetes 6.6% (3.7%, 9.6%) <0.001 6.7% (2.4%, 11.2%) 0.002 Donor History of Hypertension 7.2% (5.5%, 8.8%) <0.001 6.9% (4.6%, 9.4%) <0.001
Donor Smoking History - NS 1.7% (-0.1%, 3.6%) 0.062
Recipient Age (Years) <0.001 <0.001
<40 - - - -
40-49 0.2% (-1.6%, 2.1%) 0.802 -2.2% (-4.7%, 0.3%) 0.086
50-59 -3.7% (-5.4%, -1.9%) <0.001 -7.8% (-10.1%, -5.4%) <0.001 60+ -7.2% (-9.0%, -5.3%) <0.001 -11.7% (-14.1%, -9.2%) <0.001
Recipient Ethnicity <0.001 <0.001
White - - - -
Asian -10.6% (-12.3%, -8.9%) <0.001 -10.8% (-13.1%, -8.4%) <0.001
Black 11.2% (8.4%, 14.1%) <0.001 9.0% (5.2%, 12.9%) <0.001
Other -4.6% (-9.4%, 0.4%) 0.071 -3.4% (-10.3%, 4.0%) 0.355
Recipient Diabetes -3.9% (-6.1%, -1.7%) <0.001 4.6% (0.6%, 8.8%) 0.023 Recipient Waiting Time
(Months) 0.010 NS
<12 - - - -
12-23 -0.5% (-2.3%, 1.3%) 0.570 - -
24-47 0.9% (-0.8%, 2.7%) 0.290 - -
48+ 2.7% (0.8%, 4.8%) 0.006 - -
Recipient Dialysis at Transplant 0.009 0.061
Haemodialysis - - - -
Peritoneal Dialysis -2.1% (-3.5%, -0.7%) 0.003 -2.1% (-4.0%, -0.2%) 0.032 Not on Dialysis -5.9% (-17.9%, 7.9%) 0.384 -9.8% (-25.1%, 8.6%) 0.278
Transplant Year <0.001 <0.001
2000 - 2004 - - - -
2005 - 2009 -8.8% (-10.4%, -7.0%) <0.001 -11.8% (-14.1%, -9.5%) <0.001 2010 - 2013 -12.8% (-14.6%, -11.1%) <0.001 -13.5% (-15.9%, -11.1%) <0.001 2014 - 2016 -12.3% (-14.2%, -10.4%) <0.001 -13.3% (-15.9%, -10.6%) <0.001
CIT (Hours) 0.024 0.002
<12 - - - -
12-15 0.9% (-0.9%, 2.8%) 0.345 2.6% (-0.1%, 5.5%) 0.063
16-19 2.2% (0.3%, 4.2%) 0.026 4.0% (1.1%, 7.0%) 0.007
20+ 2.9% (0.8%, 5.0%) 0.006 5.9% (2.7%, 9.1%) <0.001
CRF at Transplant <0.001 <0.001
0% - - - -
1-85% -0.1% (-1.7%, 1.4%) 0.869 1.4% (-0.6%, 3.4%) 0.180
>85% 5.8% (3.0%, 8.7%) <0.001 5.9% (3.0%, 8.9%) <0.001
Results are from multivariable general linear models, with the log10-transformed creatinine levels as the dependent variable. All factors in Table 1 with >90% data completeness were considered for inclusion in the models, with variable selection using a backwards stepwise approach. The resulting coefficients were then antilogged, and converted into percentage differences between groups. The final models were based on N=9603 and N=5616 for male and female recipients, respectively, after exclusions for missing data. Bold p- values are significant at p<0.05. NS=Not selected for inclusion in the final model by the stepwise procedure.
Table S6 – Data completeness by recipient and donor sex
Male Recipient Female Recipient
Overall Male Donor Female Donor p-Value Male Donor Female Donor p-Value Donor Factors
Age 25140 (100.0%) 8403 (100.0%) 7287 (100.0%) 1.000 5011 (100.0%) 4439 (100.0%) 1.000
BMI 24449 (97.3%) 8176 (97.3%) 7080 (97.2%) 0.626 4869 (97.2%) 4324 (97.4%) 0.486
Ethnicity 25099 (99.8%) 8393 (99.9%) 7275 (99.8%) 0.524 5006 (99.9%) 4425 (99.7%) 0.022
Terminal Creatinine 23382 (93.0%) 7847 (93.4%) 6753 (92.7%) 0.083 4670 (93.2%) 4112 (92.6%) 0.296 Cause of Death 25140 (100.0%) 8403 (100.0%) 7287 (100.0%) 1.000 5011 (100.0%) 4439 (100.0%) 1.000 Donor Type 25140 (100.0%) 8403 (100.0%) 7287 (100.0%) 1.000 5011 (100.0%) 4439 (100.0%) 1.000 History of Diabetes 24485 (97.4%) 8156 (97.1%) 7124 (97.8%) 0.007 4866 (97.1%) 4339 (97.7%) 0.052 History of Hypertension 24238 (96.4%) 8056 (95.9%) 7051 (96.8%) 0.004 4822 (96.2%) 4309 (97.1%) 0.026 Smoking History 24414 (97.1%) 8132 (96.8%) 7087 (97.3%) 0.083 4852 (96.8%) 4343 (97.8%) 0.003
HCV 25053 (99.7%) 8370 (99.6%) 7263 (99.7%) 0.594 5000 (99.8%) 4420 (99.6%) 0.098
CMV 24833 (98.8%) 8291 (98.7%) 7209 (98.9%) 0.144 4940 (98.6%) 4393 (99.0%) 0.113
Donor Risk Index 23371 (93.0%) 7755 (92.3%) 6890 (94.6%) <0.001 4582 (91.4%) 4144 (93.4%) <0.001 Recipient Factors
Age 25139 (100.0%) 8403 (100.0%) 7286 (100.0%) 0.464 5011 (100.0%) 4439 (100.0%) 1.000
Ethnicity 24934 (99.2%) 8340 (99.3%) 7226 (99.2%) 0.588 4966 (99.1%) 4402 (99.2%) 0.824
BMI 14402 (57.3%) 4876 (58.0%) 4135 (56.7%) 0.106 2836 (56.6%) 2555 (57.6%) 0.349
History of Diabetes 25140 (100.0%) 8403 (100.0%) 7287 (100.0%) 1.000 5011 (100.0%) 4439 (100.0%) 1.000
HCV 18823 (74.9%) 6333 (75.4%) 5403 (74.1%) 0.080 3776 (75.4%) 3311 (74.6%) 0.392
CMV 22424 (89.2%) 7544 (89.8%) 6499 (89.2%) 0.230 4441 (88.6%) 3940 (88.8%) 0.845
Waiting Time 25116 (99.9%) 8396 (99.9%) 7282 (99.9%) 0.781 5005 (99.9%) 4433 (99.9%) 1.000 Dialysis at Transplant 22506 (89.5%) 7553 (89.9%) 6526 (89.6%) 0.510 4471 (89.2%) 3956 (89.1%) 0.894 Transplant Year 25140 (100.0%) 8403 (100.0%) 7287 (100.0%) 1.000 5011 (100.0%) 4439 (100.0%) 1.000 Mismatch Level 25138 (100.0%) 8403 (100.0%) 7286 (100.0%) 0.494 5010 (100.0%) 4439 (100.0%) 1.000
AITx 25140 (100.0%) 8403 (100.0%) 7287 (100.0%) 1.000 5011 (100.0%) 4439 (100.0%) 1.000
CIT 24834 (98.8%) 8308 (98.9%) 7207 (98.9%) 0.878 4944 (98.7%) 4375 (98.6%) 0.725
CRF at Transplant 25139 (100.0%) 8403 (100.0%) 7286 (100.0%) 0.464 5011 (100.0%) 4439 (100.0%) 1.000 Outcomes
Initial Graft Dysfunction 20777 (82.6%) 6992 (83.2%) 5992 (82.2%) 0.107 4132 (82.5%) 3661 (82.5%) 1.000 Rejection at 3 Months 21380 (85.0%) 7110 (84.6%) 6240 (85.6%) 0.076 4255 (84.9%) 3775 (85.0%) 0.863 Rejection at 12 Months 18150 (72.2%) 6029 (71.7%) 5285 (72.5%) 0.284 3639 (72.6%) 3197 (72.0%) 0.519 Creatinine at 1 Year 21194 (84.3%) 7073 (84.2%) 6187 (84.9%) 0.207 4207 (84.0%) 3727 (84.0%) 1.000 Creatinine at 3 Years 16613 (66.1%) 5475 (65.2%) 4848 (66.5%) 0.071 3321 (66.3%) 2969 (66.9%) 0.541 Creatinine at 5 Years 13001 (51.7%) 4252 (50.6%) 3811 (52.3%) 0.035 2620 (52.3%) 2318 (52.2%) 0.951
p-Values are from Fisher’s exact tests, comparing the rates of data completeness between male and female donors, and bold values are significant at p<0.05.
Table S7 – Effect of donor/recipient mismatch by donor sex for paired donor organs
Male Donor Female Donor Interaction
Statistic Statistic (95% CI) p-Value Statistic (95% CI) p-Value p-Value
Initial Graft Dysfunction* Odds Ratio 0.88 (0.78 – 1.00) 0.057 0.86 (0.75 – 1.00) 0.051 0.815 Patient Survival Hazard Ratio 0.79 (0.67 – 0.93) 0.005 0.86 (0.72 – 1.02) 0.086 0.504 Graft Survival Hazard Ratio 1.04 (0.91 – 1.18) 0.589 1.03 (0.89 – 1.19) 0.659 0.996 One Year Creatinine % Difference -16.3% (-18.1%, -14.5%) <0.001 -17.8% (-19.6%, -15.9%) <0.001 0.275
Results are from univariable binary logistic regression (DGF/PNF), Cox regression (survival) or general linear (creatinine) models, as applicable. Only those donors where organs were transplanted into one male and one female recipient were included. In each case, statistics are reported for female recipients, compared to male recipients. Models were initially produced separately for male and female donors to generate the reported statistics. In order to compare the resulting effects, models were then produced with donor sex, recipient sex and an interaction term as factors. In the resulting models, the interaction term compared the effect of recipient sex between the donor sex groups, hence analysed the effect of donor/recipient sex mismatch. Bold p- values are significant at p<0.05.*Composite outcome of DGF or PNF
Modified STROBE Statement—checklist of items that should be included in reports of observational studies (Cohort/Cross-sectional and case-control studies)
Item No Recommendation
Title and abstract 1 (a) Indicate the study’s design with a commonly used term in the title or the abstract PAGE 1-3
(b) Provide in the abstract an informative and balanced summary of what was done and what was found PAGE 3-4
Introduction
Background/rationale 2 Explain the scientific background and rationale for the investigation being reported PAGES 5-6
Objectives 3 State specific objectives, including any prespecified hypotheses PAGE 6
Methods
Study design 4 Present key elements of study design early in the paper PAGES 6-8 Setting 5 Describe the setting, locations, and relevant dates, including periods of
recruitment, exposure, follow-up, and data collection PAGE 6 Participants 6 (a) Cohort study—Give the eligibility criteria, and the sources and
methods of selection of participants. Describe methods of follow-up PAGE 6
Case-control study—Give the eligibility criteria, and the sources and methods of case ascertainment and control selection. Give the rationale for the choice of cases and controls
Cross-sectional study—Give the eligibility criteria, and the sources and methods of selection of participants
Variables 7 Clearly define all outcomes, exposures, predictors, potential
confounders, and effect modifiers. Give diagnostic criteria, if applicable PAGES 7-8
Data sources/
measurement
8* For each variable of interest, give sources of data and details of methods of assessment (measurement). PAGES 7-9
Bias 9 Describe any efforts to address potential sources of bias N/A Study size 10 Explain how the study size was arrived at (if applicable) N/A Quantitative
variables
11 Explain how quantitative variables were handled in the analyses. If applicable, describe which groupings were chosen and why PAGES 8-9 Statistical methods 12 (a) Describe all statistical methods, including those used to control for
confounding PAGES 8-9
(b) Describe any methods used to examine subgroups and interactions PAGES 8-9
(c) Explain how missing data were addressed PAGES 8-9
(d) Cohort study—If applicable, explain how loss to follow-up was addressed N/A
Case-control study—If applicable, explain how matching of cases and controls was addressed
Cross-sectional study—If applicable, describe analytical methods taking account of sampling strategy
(e) Describe any sensitivity analyses N/A Results
Participants 13*
(a) Report numbers of individuals at each stage of study—eg numbers potentially eligible, examined for eligibility, confirmed eligible, included in the study, completing follow-up, and analyzed PAGE 6 (c) Use of a flow diagram N/A
Descriptive data 14*
(a) Give characteristics of study participants (eg demographic, clinical, social) and information on exposures and potential confounders PAGE 6 AND SUPPL TABLE 1
(b) Indicate number of participants with missing data for each variable of interest TABLES 1-3
(c) Cohort study—Summarise follow-up time (eg, average and total amount) PAGE 7, FIGURES 1-2
Outcome data 15*
Cohort study—Report numbers of outcome events or summary measures over time PAGES 11-12, TABLES 2-3
Case-control study—Report numbers in each exposure category, or summary measures of exposure
Cross-sectional study—Report numbers of outcome events or summary measures
Main results 16
(a) Give unadjusted estimates and, if applicable, confounder-adjusted estimates and their precision (eg, 95% confidence interval). Make clear which confounders were adjusted for and why they were included PAGES 9-11, TABLES 1-3 (AND SUPPL TABLES 1-6) Other analyses
17
Report other analyses done—eg analyses of subgroups and interactions, and sensitivity analyses
Discussion
Key results 18
Summarise key results with reference to study objectives PAGES 13 Limitations
19
Discuss limitations of the study, taking into account sources of potential bias or imprecision. Discuss both direction and magnitude of any potential bias PAGE 16
Interpretation 20
Give a cautious overall interpretation of results considering objectives, limitations, multiplicity of analyses, results from similar studies, and other relevant evidence PAGES 13-16
Generalisability 21 Discuss the generalisability (external validity) of the study results PAGES 14-15
*Give information separately for cases and controls in case-control studies and, if applicable, for exposed and unexposed groups in cohort and cross-sectional studies.
Note: An Explanation and Elaboration article discusses each checklist item and gives methodological
background and published examples of transparent reporting. The STROBE checklist is best used in conjunction with this article (freely available on the Web sites of PLoS Medicine at http://www.plosmedicine.org/, Annals of Internal Medicine at http://www.annals.org/, and Epidemiology at http://www.epidem.com/). Information on the STROBE Initiative is available at www.strobe-statement.org.
