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

Table 3 Landmark analysis of post-transplant malignancy risk in rejection-induced graft failure, n (%)

Variable	Post-transplant malignancy	Post-transplant malignancy risk
		Univariate		Multivariate1
		HR (95%CI)	P value	HR (95%CI)	P value
Rejection-induced graft failure
No landmark (n = 55240)	3973 (7.19)	0.44 (0.43-0.46)	< 0.001	0.70 (0.68-0.73)	< 0.001
1-year landmark (n = 7622)	58 (0.76)	0.11 (0.09-0.14)	< 0.001	0.20 (0.16-0.26)	< 0.001
2-year landmark (n = 9830)	63 (0.64)	0.09 (0.07-0.11)	< 0.001	0.16 (0.13-0.21)	< 0.001
3-year landmark (n = 11942)	69 (0.58)	0.08 (0.06-0.10)	< 0.001	0.14 (0.11-0.18)	< 0.001
5-year landmark (n = 14094)	62 (0.44)	0.06 (0.05-0.07)	< 0.001	0.11 (0.08-0.14)	< 0.001
10-year landmark (n = 11716)	44 (0.38)	0.05 (0.04-0.07)	< 0.001	0.09 (0.07-0.12)	< 0.001
15-year landmark (n = 5545)	25 (0.45)	0.07 (0.05-0.11)	< 0.001	0.11 (0.07-0.16)	< 0.001
20-year landmark (n = 1882)	5 (0.27)	0.05 (0.02-0.11)	< 0.001	0.07 (0.03-0.16)	< 0.001
Excluding rejection-related retransplantation
No landmark (n = 39334)	3222 (8.19)	0.53 (0.51-0.55)	< 0.001	0.74 (0.72-0.77)	< 0.001
1-year landmark (n = 5690)	51 (0.90)	0.14 (0.11-0.18)	< 0.001	0.22 (0.17-0.30)	< 0.001
2-year landmark (n = 7022)	54 (0.77)	0.11 (0.08-0.14)	< 0.001	0.18 (0.14-0.24)	< 0.001
3-year landmark (n = 8240)	56 (0.68)	0.09 (0.07-0.12)	< 0.001	0.15 (0.12-0.20)	< 0.001
5-year landmark (n = 9373)	54 (0.58)	0.07 (0.06-0.10)	< 0.001	0.12 (0.10-0.16)	< 0.001
10-year landmark (n = 7655)	33 (0.43)	0.06 (0.04-0.08)	< 0.001	0.09 (0.07-0.13)	< 0.001
15-year landmark (n = 3694)	16 (0.43)	0.07 (0.04-0.11)	< 0.001	0.09 (0.05-0.15)	< 0.001
20-year landmark (n = 1283)	5 (0.39)	0.06 (0.03-0.15)	< 0.001	0.20 (0.11-0.36)	< 0.001
Excluding rejection-related mortality
No landmark (n = 25856)	1332 (5.15)	0.32 (0.30-0.33)	< 0.001	0.69 (0.65-0.73)	< 0.001
1-year landmark (n = 3077)	14 (0.45)	0.08 (0.05-0.14)	< 0.001	0.21 (0.13-0.36)	< 0.001
2-year landmark (n = 4099)	17 (0.41)	0.07 (0.04-0.11)	< 0.001	0.18 (0.11-0.28)	< 0.001
3-year landmark (n = 5075)	21 (0.41)	0.07 (0.04-0.10)	< 0.001	0.17 (0.11-0.26)	< 0.001
5-year landmark (n = 5910)	13 (0.22)	0.04 (0.02-0.06)	< 0.001	0.09 (0.05-0.15)	< 0.001
10-year landmark (n = 4662)	17 (0.36)	0.07 (0.04-0.10)	< 0.001	0.13 (0.08-0.21)	< 0.001
15-year landmark (n = 2068)	12 (0.58)	0.12 (0.07-0.20)	< 0.001	0.20 (0.12-0.36)	< 0.001
20-year landmark (n = 662)	2 (0.30)	0.07 (0.02-0.26)	< 0.001	0.24 (0.09-0.60)	0.003

¹Multivariate analysis adjusted for age, sex, race/ethnicity, body mass index, performance status, ABO blood group, ABO match status, human leukocyte antigen match status, oncogenic virus seropositivity, donor type, and immunosuppressive therapy.

CI: Confidence interval; HR: Hazard ratio.