Novel association between graft rejection and post-transplant malignancy in solid organ transplantation

Table 1 Peri-transplant clinical and immunological characteristics, n (%)/mean ± SD

Variable	Transplant organ type						P value
	Total	Kidney	Liver	Heart	Lung	Pancreas
Number of patients	579905	386878	108390	45046	37643	1948
Age (years)	50.6 ± 13.2	49.4 ± 13.8	52.8 ± 10.9	52.6 ± 12.4	55.0 ± 12.9	41.2 ± 9.9	< 0.001
Female	220273 (38.0)	153116 (39.6)	39064 (36.0)	10967 (24.3)	15971 (42.4)	1155 (59.3)	< 0.001
Race							< 0.001
White	337778 (58.3)	194112 (50.2)	80251 (74.0)	31015 (68.9)	30576 (81.2)	1824 (93.7)
Black	121654 (21.0)	101431 (26.2)	8244 (7.6)	8626 (19.2)	3292 (8.7)	61 (3.1)
Hispanic	82617 (14.2)	61585 (15.9)	14579 (13.5)	3612 (8.0)	2791 (7.4)	50 (2.6)
Asian	29030 (5.0)	22979 (5.9)	3979 (3.7)	1346 (3.0)	721 (1.9)	5 (0.3)
Other	8786 (1.5)	6755 (1.7)	1323 (1.2)	441 (1.0)	260 (0.7)	7 (0.4)
Body mass index							< 0.001
< 25 kg/m2	203355 (35.1)	135071 (34.9)	33191 (30.6)	15905 (35.3)	18249 (48.5)	939 (48.2)
25-30 kg/m2	193173 (33.3)	125232 (32.4)	37188 (34.3)	16617 (36.9)	13423 (35.7)	713 (36.6)
	174940 (30.2)	118752 (30.7)	37658 (34.7)	12374 (27.5)	5885 (15.6)	271 (13.9)
Performance status							< 0.001
ECOG ≥ 2	164472 (28.4)	47819 (12.4)	59733 (55.1)	29247 (64.9)	27429 (72.9)	244 (12.5)
ABO blood group							< 0.001
O	257752 (44.4)	175278 (45.3)	47570 (43.9)	17122 (38.0)	16954 (45.0)	828 (42.5)
A	217263 (37.5)	141574 (36.6)	41074 (37.9)	18848 (41.8)	14941 (39.7)	826 (42.4)
B	77272 (13.3)	51850 (13.4)	14320 (13.2)	6621 (14.7)	4262 (11.3)	219 (11.2)
AB	27608 (4.8)	18166 (4.7)	5426 (5.0)	2455 (5.4)	1486 (3.9)	75 (3.9)
ABO mismatch	4844 (0.8)	3810 (1.0)	1020 (0.9)	5 (0.0)	6 (0.0)	3 (0.2)	< 0.001
HLA mismatch1	477075 (82.3)	355193 (91.8)	46501 (42.9)	39707 (88.1)	33761 (89.7)	1913 (98.2)	< 0.001
CMV seropositive	297861 (51.4)	198117 (51.2)	58330 (53.8)	21827 (48.5)	18847 (50.1)	740 (38.0)	< 0.001
EBV seropositive	354259 (61.1)	229647 (59.4)	65178 (60.1)	29899 (66.4)	28268 (75.1)	1267 (65.0)	< 0.001
HBV seropositive	11417 (2.0)	5819 (1.5)	4492 (4.1)	614 (1.4)	478 (1.3)	14 (0.7)	< 0.001
HCV seropositive	46978 (8.1)	14395 (3.7)	30915 (28.5)	901 (2.0)	732 (1.9)	35 (1.8)	< 0.001
HIV seropositive	3171 (0.5)	2522 (0.7)	474 (0.4)	118 (0.3)	54 (0.1)	3 (0.2)	< 0.001
Donor type							< 0.001
Deceased	442198 (76.3)	254296 (65.7)	103331 (95.3)	45027 (100.0)	37607 (99.9)	1937 (99.4)
Living	137671 (23.7)	132547 (34.3)	5059 (4.7)	19 (0.0)	36 (0.1)	10 (0.5)
Induction therapy	444018 (76.6)	311970 (80.6)	68458 (63.2)	32960 (73.2)	28975 (77.0)	1655 (85.0)	< 0.001
rATG	163501 (28.2)	147287 (38.1)	7401 (6.8)	6495 (14.4)	1228 (3.3)	1090 (56.0)	< 0.001
Basiliximab	107968 (18.6)	66528 (17.2)	15357 (14.2)	8835 (19.6)	17144 (45.5)	104 (5.3)	< 0.001
Alemtuzumab	39680 (6.8)	36968 (9.6)	425 (0.4)	380 (0.8)	1645 (4.4)	262 (13.4)	< 0.001
Tacrolimus	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	NA
Cyclosporine	26218 (4.5)	18297 (4.7)	1874 (1.7)	3805 (8.4)	2173 (5.8)	69 (3.5)	< 0.001
Mycophenolate mofetil	20502 (3.5)	17529 (4.5)	1638 (1.5)	945 (2.1)	337 (0.9)	53 (2.7)	< 0.001
Azathioprine	19417 (3.3)	12275 (3.2)	1530 (1.4)	3368 (7.5)	2167 (5.8)	77 (4.0)	< 0.001
Glucocorticoid	363820 (62.7)	249121 (64.4)	60017 (55.4)	29076 (64.5)	24400 (64.8)	1206 (61.9)	< 0.001
Sirolimus	4634 (0.8)	4243 (1.1)	314 (0.3)	45 (0.1)	4 (0.0)	28 (1.4)	< 0.001
Everolimus	157 (0.0)	127 (0.0)	12 (0.0)	17 (0.0)	1 (0.0)	0 (0.0)	< 0.001
Rituximab	3731 (0.6)	1853 (0.5)	1456 (1.3)	106 (0.2)	305 (0.8)	11 (0.6)	< 0.001
Maintenance therapy	564847 (97.4)	378428 (97.8)	104051 (96.0)	43318 (96.2)	37229 (98.9)	1821 (93.5)	< 0.001
rATG	321 (0.1)	290 (0.1)	17 (0.0)	9 (0.0)	3 (0.0)	2 (0.1)	< 0.001
Basiliximab	329 (0.1)	215 (0.1)	57 (0.1)	27 (0.1)	28 (0.1)	2 (0.1)	0.510
Alemtuzumab	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	NA
Tacrolimus	144998 (25.0)	93180 (24.1)	26497 (24.4)	13778 (30.6)	11312 (30.1)	231 (11.9)	< 0.001
Cyclosporine	121422 (20.9)	91543 (23.7)	13157 (12.1)	10375 (23.0)	6225 (16.5)	122 (6.3)	< 0.001
Mycophenolate mofetil	451378 (77.8)	309403 (80.0)	77099 (71.1)	37025 (82.2)	26278 (69.8)	1573 (80.7)	< 0.001
Azathioprine	62294 (10.7)	41029 (10.6)	6788 (6.3)	4820 (10.7)	9555 (25.4)	102 (5.2)	< 0.001
Glucocorticoid	457017 (78.8)	292533 (75.6)	86605 (79.9)	40619 (90.2)	36116 (95.9)	1144 (58.7)	< 0.001
Sirolimus	17850 (3.1)	14636 (3.8)	2371 (2.2)	461 (1.0)	148 (0.4)	234 (12.0)	< 0.001
Everolimus	2307 (0.4)	1606 (0.4)	483 (0.4)	204 (0.5)	7 (0.0)	7 (0.4)	< 0.001
Rituximab	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	NA
Antirejection therapy	33922 (5.8)	16972 (4.4)	8325 (7.7)	5049 (11.2)	3530 (9.4)	46 (2.4)	< 0.001
rATG	5334 (0.9)	4102 (1.1)	438 (0.4)	596 (1.3)	180 (0.5)	18 (0.9)	< 0.001
Basiliximab	1626 (0.3)	1335 (0.3)	181 (0.2)	50 (0.1)	57 (0.2)	3 (0.2)	< 0.001
Alemtuzumab	99 (0.0)	75 (0.0)	14 (0.0)	1 (0.0)	9 (0.0)	0 (0.0)	0.050
Tacrolimus	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	NA
Cyclosporine	2974 (0.5)	1677 (0.4)	1087 (1.0)	159 (0.4)	50 (0.1)	1 (0.1)	< 0.001
Mycophenolate mofetil	1040 (0.2)	620 (0.2)	280 (0.3)	96 (0.2)	43 (0.1)	1 (0.1)	< 0.001
Azathioprine	1792 (0.3)	1094 (0.3)	564 (0.5)	85 (0.2)	49 (0.1)	0 (0.0)	< 0.001
Glucocorticoid	30156 (5.2)	14174 (3.7)	7937 (7.3)	4690 (10.4)	3319 (8.8)	36 (1.8)	< 0.001
Sirolimus	128 (0.0)	100 (0.0)	16 (0.0)	7 (0.0)	5 (0.0)	0 (0.0)	0.101
Everolimus	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	NA
Rituximab	456 (0.1)	164 (0.0)	24 (0.0)	148 (0.3)	119 (0.3)	1 (0.1)	< 0.001

¹HLA mismatch referred to a mismatch at one or more loci (HLA-A, -B, -DR) between the recipients and their donors.

CMV: Cytomegalovirus; EBV: Epstein-Barr virus; ECOG: Eastern Cooperative Oncology Group; HBV: Hepatitis B virus; HCV: Hepatitis C virus; HIV: Human immunodeficiency virus; HLA: Human leukocyte antigen; NA: Not available; rATG: Rabbit anti-thymocyte globulin; SD: Standard deviation.