Research Article
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/m2) | 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/m2) | 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/m2) | 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 | | |
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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.
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