Outcomes of Combined Heart-Kidney Transplantation in Older Recipients
Table 1
Demographic characteristics of patients undergoing heart-kidney transplantation stratified by age.
Age <65
Age ≥65
value
N = 1,650
N = 372
81.60%
18.40%
Recipient
Age (years), median (IQR)
54 (46, 60)
67 (66, 68)
<0.001
Male sex, no. (%)
1,259 (76.30)
319 (85.75)
<0.001
Race/ethnicity, no. (%)
<0.001
White
808 (48.97)
230 (61.83)
Black
589 (35.70)
91 (24.46)
Hispanic
146 (8.85)
32 (8.60)
Other
107 (6.48)
19 (5.11)
BMI (kg/m2), mean (SD)
26.5 (23.0, 30.3)
26.3 (23.9, 29.2)
0.916
Creatinine (mg/dL), median (IQR)
2.7 (1.9, 4.3)
2.2 (1.7, 3.1)
<0.001
Dialysis prior to transplant, no. (%)
851 (52.76)
109 (30.28)
<0.001
Total bilirubin (mg/dL), median (IQR)
0.7 (0.5, 1.1)
0.7 (0.5, 1.2)
0.293
Diabetes, no. (%)
716 (43.39)
173 (46.51)
0.275
Heart failure etiology, no. (%)
<0.001
Nonischemic cardiomyopathy
623 (37.76)
101 (27.15)
Ischemic cardiomyopathy
592 (35.88)
208 (55.91)
Hypertrophic/restrictive cardiomyopathy
105 (6.36)
36 (9.68)
Failed OHT
252 (15.27)
17 (4.57)
Congenital heart disease
31 (1.88)
1 (0.27)
Other/unknown
47 (2.85)
9 (2.42)
ICU at time of transplant, no. (%)
753 (46.54)
170 (46.70)
0.955
Mechanical ventilation, no. (%)
16 (0.97)
8 (2.15)
0.057
Bridging method
0.186
None
429 (26.00)
99 (26.61)
Inotropes
486 (29.45)
107 (28.76)
IABP
212 (12.85)
64 (17.20)
Durable VAD
414 (25.09)
82 (22.04)
Temporary VAD/ECMO
109 (6.61)
20 (5.38)
Karnofsky index, no. (%)
0.316
≥80%
138 (8.94)
24 (6.72)
50–70%
346 (22.41)
88 (24.65)
≤40%
1,060 (68.65)
245 (68.63)
Cardiac index (L/min/m2), median (IQR)
2.39 (1.94, 2.91)
2.36 (1.94, 2.90)
0.615
Mean PAP (mmHg), median (IQR)
30 (23, 37)
28 (23, 36)
0.121
Days on waitlist, median (IQR)
74.5 (22, 235)
57.5 (18, 185)
0.039
Heart ischemic time (hours), median (IQR)
32 (25, 38)
32 (25, 38)
0.703
Donor
Age (years), median (IQR)
30 (22, 39)
32 (24, 43)
<0.001
Male sex, no. (%)
1,195 (72.42)
278 (74.73)
0.366
Race, no. (%)
0.014
White
1,026 (62.87)
224 (60.38)
Black
240 (14.71)
40 (10.78)
Hispanic
330 (20.22)
92 (24.80)
Other
36 (2.21)
15 (4.04)
Mechanism of death, no. (%)
0.506
Trauma
803 (48.67)
167 (44.89)
Cerebrovascular
310 (18.79)
73 (19.62)
Drug overdose
246 (14.91)
65 (17.47)
Other
291 (17.64)
67 (18.01)
BMI (kg/m2), mean (SD)
26.5 (23.3, 30.3)
26.2 (23.4, 30.3)
0.952
Diabetes, no. (%)
40 (2.44)
10 (2.72)
0.754
Recipient-donor matching
Sex-matched, no. (%)
1,242 (75.27)
283 (76.08)
0.745
Race-matched, no. (%)
679 (41.15)
116 (44.62)
0.220
HLA-matched, no. (%)b
248 (15.27)
39 (10.38)
0.016
ABO-identical, no. (%)
1,389 (84.18)
306 (82.26)
0.363
CMV-matched, no. (%)c
837 (50.73)
197 (52.96)
0.437
aDonor and recipient are considered HLA-matched if there are fewer than 4 mismatched loci. bAny combination other than CMV D-/R+. BMI, body mass index; CMV, cytomegalovirus; ECMO, extracorporeal membrane oxygenation; HLA, human leukocyte antigen; IABP, intraaortic balloon pump; PAP, pulmonary artery pressure; VAD, ventricular assist device.
