Outcomes of Combined Heart-Kidney Transplantation in Older Recipients

Table 2

Multivariable Cox proportional hazards model for one-year mortality following combined heart and kidney transplantation.

	Univariable analysis		Final multivariable model
	Hazard ratio (95% CI)	value	Hazard ratio (95% CI)	value
Age ≥65	0.95 (0.68–1.34)	0.771	0.91 (0.63–1.29)	0.572
Female recipient	1.11 (0.82–1.52)	0.476
Recipient race/ethnicity
White	Reference	Reference
Black	0.89 (0.66–1.19)	0.423
Hispanic	0.75 (0.44–1.26)	0.271
Other	1.16 (0.70–1.93)	0.562
Recipient BMI (per kg/m^2)	1.04 (1.01–1.06)	0.006
Creatinine (per mg/dL)	1.04 (0.99–1.09)	0.110	1.05 (1.00–1.11)	0.035
Dialysis prior to transplant	1.32 (1.02–1.71)	0.038
Total bilirubin (per mg/dL)	1.03 (1.01–1.05)	0.002	1.03 (1.01–1.05)	0.002
Recipient diabetes	1.22 (0.94–1.57)	0.140
Cardiac diagnosis
NICM	Reference	Reference
Ischemic cardiomyopathy	1.17 (0.87–1.57)	0.303
HCM/RCM	1.20 (0.72–2.00)	0.490
Failed OHT	0.76 (0.48–1.22)	0.259
Congenital heart disease	1.20 (0.44–3.29)	0.717
Other/unknown	0.97 (0.42–2.22)	0.940
ICU at the time of transplantation	1.15 (0.89–1.50)	0.281
Mechanical ventilation at the time of transplantation	3.48 (1.72–7.04)	0.001	2.90 (1.33–6.31)	0.007
Bridging method
None	Reference	Reference	Reference	Reference
Inotropes	0.67 (0.46–0.97)	0.033	0.78 (0.53–1.15)	0.206
IABP	0.95 (0.61–1.47)	0.811	1.07 (0.68–1.69)	0.759
Durable VAD	1.10 (0.78–1.56)	0.578	1.26 (0.87–1.83)	0.220
Temporary VAD/ECMO	1.44 (0.87–2.39)	0.156	1.44 (0.82–2.52)	0.203
Karnofsky index, no. (%)
≥80%	Reference	Reference
50–70%	1.58 (0.86–2.89)	0.142
≤40%	1.55 (0.88–2.73)	0.129
Cardiac index (per L/min/m^2)	1.00 (0.83–1.19)	0.965
Mean PAP (per mmHg)	1.03 (1.01–1.04)	<0.001
Waitlist time (per day)	1.00 (1.00–1.00)	0.171
Ischemic time (per hour)	1.19 (1.06–1.33)	0.003	1.17 (1.04–1.31)	0.007
Donor age (per year)	1.01 (1.00–1.03)	0.011	1.02 (1.00–1.03)	0.007
Donor race/ethnicity
White	Reference	Reference
Black	1.11 (0.77–1.61)	0.574
Hispanic	0.86 (0.61–1.22)	0.399
Other	1.77 (0.93–3.35)	0.082
Mechanism of death
Trauma	Reference	Reference
Cerebrovascular	1.35 (0.96–1.88)	0.082
Drug overdose	1.09 (0.73–1.63)	0.657
Other	1.27 (0.89–1.80)	0.187
Donor BMI (per kg/m^2)	1.01 (0.99–1.03)	0.277
Donor diabetes	1.07 (0.48–2.42)	0.861
Sex-matched	1.04 (0.77–1.40)	0.781
Race-matched	1.08 (0.83–1.40)	0.583
HLA-matched	1.28 (0.86, 1.95)	0.210
ABO-identical	1.06 (0.75, 1.49)	0.755

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. Age as categorical variable.