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. 2021 Jan 26;7(2):e663. doi: 10.1097/TXD.0000000000001119

FIGURE 5.

FIGURE 5.

Subclinical chronic allograft injury scores at 6 mo are prognostic for the composite endpoint. A, Receiver operating characteristic (ROC) curve analysis depicting good prognostic performance of the composite Banff chronic allograft injury score (ci + ct + cg + cv) for the primary composite endpoint. The dotted line represents the line of identity. The area under the ROC curve (AUC) was significant at P = 0.003. B, Kaplan-Meier plot comparing time to the composite endpoint between the group with subclinical ci + ct + cg + cv score ≥ 2 vs < 2 by the log-rank test. Categorizations were based on the optimal cutoff value determined by the Youden index in (A). The adjusted hazard ratio (aHR) with 95% confidence interval (CI) for subclinical ci + ct + cg + cv score ≥ 2 and the primary endpoint was derived from a multivariable Cox proportional hazards regression. The association between the subclinical ci + ct + cg + cv score ≥ 2 and primary endpoint was independent of subclinical inflammation (SCI), age at transplant, race, donor type, sex, pretransplant diabetes status, repeat transplantation, and the presence of donor-specific antibody (DSA) at the surveillance biopsy. The final model used forced entry of the same clinical covariates used in Table 4 and was significant at P = 0.01 with chi-square = 21.28 and 9 df. Hatch marks represent censored cases in each group. C, Further characterization of the association between subclinical pathology and the composite endpoint, illustrated in a Kaplan-Meier plot comparing time to the composite endpoint between 4 subgroups: (1) cases with no major surveillance abnormalities (NMA) and subclinical ci + ct + cg + cv score < 2 (black dotted line), (2) cases with NMA and subclinical ci + ct + cg + cv score ≥ 2 (gray dotted line), (3) cases with SCI and subclinical ci + ct + cg + cv score < 2 (solid black line), and (4) cases with SCI and subclinical ci + ct + cg + cv score ≥ 2 (solid gray line) by the log-rank test. The same modeling approach was used as in (B) to derive the aHR for the composite endpoint. The aHR represents the association between the SCI and subclinical ci + ct + cg + cv score ≥ 2 group compared to the NMA and subclinical ci + ct + cg + cv score < 2 reference group. The final model was significant at P = 0.01 with chi-square = 21.77 and 9 df. cg, chronic glomerulopathy; ci, interstitial fibrosis; ct, tubular atrophy; cv, chronic vasculopathy.