TABLE 1.
Pre-transplant high risk factors
| Risk Factors | Weight | Odds Ratio | Upper 95% CI | Lower 95% CI | p-value | |
|---|---|---|---|---|---|---|
| Comorbities | Recipient Age: >70yo | 2.1 | 2.069 | 1.387 | 3.086 | 0.000 |
| Recipient Age: 55-70yo | 1.2 | 1.216 | 1.075 | 1.375 | 0.002 | |
| Previous Cardiac Surgery | 1.3 | 1.269 | 1.117 | 1.442 | 0.000 | |
| Etiology: Congential | 2.3 | 2.319 | 1.754 | 3.068 | 0.000 | |
| Etiology: Amyloidosis | 1.8 | 1.755 | 0.811 | 3.798 | 0.154 | |
| Diabetes complicated by CVA | 1.4 | 1.354 | 0.907 | 2.022 | 0.138 | |
| eGFR < 33 | 2.8 | 2.813 | 2.374 | 3.333 | 0.000 | |
| eGFR 33-53 | 1.4 | 1.380 | 1.202 | 1.584 | 0.000 | |
| Total Bilirubin > 2 | 1.7 | 1.745 | 1.508 | 2.020 | 0.000 | |
| Acuity | Intubated | 1.8 | 1.784 | 1.338 | 2.379 | 0.000 |
| Hospitalized | 1.2 | 1.172 | 1.038 | 1.323 | 0.011 | |
| Mechanical Supprt | RVAD-only | 4.7 | 4.739 | 1.982 | 11.331 | 0.000 |
| ECMO | 3.9 | 3.852 | 1.993 | 7.446 | 0.000 | |
| Extracorporeal LVAD | 2.7 | 2.748 | 1.836 | 4.114 | 0.000 | |
| Total Artifical Heart | 2.4 | 2.400 | 1.311 | 4.391 | 0.005 | |
| Paracorporeal LVAD | 1.2 | 1.250 | 0.969 | 1.612 | 0.086 | |
| Donors | Hepatitis C (+) donor | 2.1 | 2.127 | 1.124 | 4.026 | 0.020 |
| Insulin dependent donor | 1.8 | 1.795 | 1.010 | 3.191 | 0.046 | |
| Donor Age: 50 - 59yo | 1.7 | 1.686 | 1.391 | 2.044 | 0.000 | |
| Donor Age: 40 - 49yo | 1.5 | 1.464 | 1.258 | 1.703 | 0.000 | |
| Donor Age: 30 - 39yo | 1.3 | 1.265 | 1.086 | 1.473 | 0.003 | |
| Pairing | Ischemic Time >6 hrs | 1.7 | 1.699 | 1.041 | 2.771 | 0.034 |
| Ischemic Time 4-6 hrs | 1.4 | 1.436 | 1.255 | 1.644 | 0.000 | |
| Female donor : Male recipient | 1.2 | 1.230 | 1.032 | 1.467 | 0.021 | |
| Female donor : Female recipient | 1.2 | 1.189 | 0.997 | 1.419 | 0.054 |
Regression analysis included the following variables:
Recipient: Intubated at the time of transplant, UNOS Status 1A, UNOS Status 1B, Hospitalized in Intensive Care Unit at time of transplant, Hospitalized at the time of transplant, Hepatitis C+ Recipient, Previous Cardiac Surgery, BMI: <18.5 (underweight), BMI >35, Recipient eGRF (ml/min) < 33, Recipient eGRF (ml/min) 33 – 53, Diabetes complicated by PVD, Diabetes complicated by CVA, Etiology: Ischemic Cardiomyopathy, Etiology: Congential, Etiology: Restrictive, Etiology: Hypertropic, Etiology: Valvular, Etiology: Sarcoidosis, Etiology: Amyloid, Etiology: other, ECMO at time of transplant Total bilirubin > 2.0 mg/dl, Recipient Age (yo): 55 – 70, Recipient Age (yo): ≥ 70, RVAD at the time of transplant, BVAD at the time of transplant, implantable VAD at the time of transplant, extracorporeal LVAD at the time of transplant, paracorporeal LVAD at the time of transplant, total artificial heart at the time of transplant, number of previous heart transplants, transplant in the past 90 days, mean center OHT volume (tx/year), Transplant Year.
Donor: Ischemic Time 2 – 4 1 hrs, Ischemic Time 4 – 6hrs, Ischemic Time > 6 hrs, Female Donor to 2M ale Recipient, Female Donor to Female Recipient, Male Donor to Female Recipient, Donor 3e GRF (ml/min): 30-60, Donor eGRF (ml/min): < 33, Donor Age (yo): 30 – 39, Donor Age (yo): 40 4– 49, Donor Age (yo): 50 – 59, Donor Insulin Dependence, Hepatitis C+ Donor.
* The regression model accounted for center volume (OR=0.995, 0.992-0.999; p=0.01) and transplant year (OR=0.97, 0.94-1.00, p=0.09). However, because these variables were not donor or recipient characteristics they were not included as part of the risk score.