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

Table 8 Time-dependent Cox proportional hazards regression analysis of rejection-induced graft failure risk in post-transplant malignancy stratified by clinical characteristics

Covariate (Time-dependent)	Clinical characteristics	Rejection-induced graft failure risk
		Univariate		Multivariate1
		HR (95%CI)	P value	HR (95%CI)	P value
Post-transplant malignancy	Age ≤ 51	0.93 (0.89-0.97)	0.002	1.17 (1.11-1.23)	< 0.001
	Age > 51	0.98 (0.93-1.03)	0.37	1.06 (1.00-1.11)	0.04
	BMI < 25	0.84 (0.80-0.88)	< 0.001	1.11 (1.05-1.17)	< 0.001
	BMI ≥ 25	0.80 (0.76-0.84)	< 0.001	1.12 (1.07-1.18)	< 0.001
	HLA match	0.77 (0.66-0.90)	0.001	0.95 (0.81-1.12)	0.52
	HLA mismatch2	0.81 (0.79-0.84)	< 0.001	1.13 (1.09-1.18)	< 0.001
	Living donor	0.77 (0.72-0.83)	< 0.001	1.12 (1.08-1.17)	< 0.001
	Deceased donor	0.82 (0.79-0.86)	< 0.001	1.13 (1.05-1.21)	< 0.001
	Induction therapy	0.80 (0.77-0.83)	< 0.001	1.10 (1.06-1.15)	< 0.001
	No induction therapy	0.84 (0.79-0.90)	< 0.001	1.16 (1.08-1.23)	< 0.001
	Year of transplant ≤ 2005	0.86 (0.83-0.90)	< 0.001	1.12 (0.97-1.28)	0.12
	Year of transplant > 2005	0.85 (0.81-0.90)	< 0.001	1.04 (0.97-1.10)	0.27

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. Subgroup analyses excluded adjustment for the specific subgroup variable (e.g., age subgroups were not adjusted for age but adjusted for all other variables).

²Human leukocyte antigen mismatch referred to a mismatch at one or more loci (human leukocyte antigen-A, -B, -DR) between the recipients and their donors.

CI: Confidence interval; HR: Hazard ratio; HLA: Human leukocyte antigen.