Table 2.
Association of recipient and donor characteristics with immunosuppression regimen from multi-level model including center effects for ISx regimen vs. reference regimen (Tacrolimus+MPA/AZA+Prednisone)
| Tac+MPA/AZA | Tac alone, Tac+Pred | SRL-based | CSA-based | Other | |
|---|---|---|---|---|---|
| aOR (95% CI) | |||||
| Age Group | |||||
| <18 | 0.67 (0.52–0.86)† | 1.13 (0.84–1.52) | 0.77 (0.53–1.13) | 0.42 (0.27–0.66)‡ | 0.70 (0.52–0.95)* |
| 18–30 | 0.91 (0.78–1.07) | 0.89 (0.72–1.10) | 0.98 (0.77–1.24) | 0.55 (0.40–0.74)‡ | 0.90 (0.74–1.09) |
| 31–45 | Reference | Reference | Reference | Reference | |
| 46–59 | 1.06 (0.95–1.19) | 1.20 (1.04–1.39) † | 1.11 (0.94–1.31) | 1.43(1.19–1.71) ‡ | 1.16 (1.02–1.33)* |
| >=60 | 1.09 (0.96–1.25) | 1.50 (1.28–1.76) ‡ | 1.12 (0.93–1.37) | 1.87 (1.53–2.30) ‡ | 1.10(0.95–1.29) |
| Female | 0.98 (0.90–1.07) | 0.87 (0.78–0.97) † | 0.90 (0.79–1.03) | 0.93 (0.81–1.07) | 0.93 (0.84–1.03) |
| Race Group | |||||
| White | Reference | Reference | Reference | Reference | Reference |
| Black | 0.90 (0.80–1.03) | 1.00 (0.86–1.17) | 0.98 (0.82–1.17) | 0.69 (0.56–0.86)† | 0.93 (0.80–1.07) |
| Other | 0.93 (0.81–1.06) | 0.91 (0.77–1.07) | 0.76 (0.62–0.94) † | 0.98 (0.80–1.21) | 0.91 (0.78–1.07) |
| Cause of ESRD | |||||
| Diabetes | Reference | Reference | Reference | Reference | Reference |
| Glomerulonephritis | 0.80 (0.70–0.92)† | 0.82 (0.69–0.97)* | 1.03 (0.84–1.26) | 0.97 (0.79–1.19) | 0.88 (0.75–1.02) |
| Hypertension | 0.96 (0.84–1.10) | 0.90 (0.77–1.06) | 1.21 (0.99–1.48) | 0.98 (0.80–1.21) | 0.99 (0.85–1.15) |
| Polycystic kidney Disease | 1.16 (0.98–1.37) | 1.00 (0.81–1.23) | 1.23 (0.96–1.59) | 0.98 (0.75–1.28) | 0.95 (0.78–1.16) |
| Other | 0.98 (0.86–1.12) | 0.99 (0.84–1.16) | 1.21 (0.98–1.48) | 0.92 (0.74–1.14) | 0.99 (0.85–1.16) |
| Previous kidney transplant | 0.49 (0.41–0.56)‡ | 0.74 (0.63–0.88)† | 0.81 (0.67–0.99)* | 0.61 (0.48–0.77)‡ | 0.81 (0.69–0.99)† |
| ESRD duration | |||||
| None | 1.04 (0.92–1.17) | 1.14 (0.98–1.32) | 1.18 (0.99–1.41) | 0.95 (0.78–1.17) | 1.12 (0.97–1.29) |
| 0–24 | Reference | Reference | Reference | Reference | Reference |
| 25–60 | 0.95 (0.85–1.06) | 0.97 (0.84–1.12) | 1.05 (0.89–1.25) | 0.94 (0.78–1.13) | 1.12 (0.98–1.28) |
| >60 | 0.87 (0.75–1.00) | 1.06 (0.89–1.26) | 1.17 (0.95–1.43) | 1.13 (0.91–1.42) | 1.25(1.06–1.47)† |
| Missing | 1.01 (0.73–1.40) | 1.17 (0.80–1.71) | 1.30 (0.83–2.06) | 1.16 (0.69–1.95) | 1.06 (0.72–1.59) |
| HLA mismatches | |||||
| Zero A, B, and DR | Reference | Reference | Reference | Reference | Reference |
| Zero DR | 0.69 (0.60–0.80)‡ | 0.96 (0.79–1.16) | 0.76(0.61–0.95)* | 0.67 (0.53–0.83)‡ | 0.74 (0.62–0.87)‡ |
| Other | 0.69(0.60–0.80)‡ | 1.04 (0.86–1.26) | 0.83(0.67–1.04) | 0.65 (0.52–0.82)‡ | 0.78 (0.66–0.92)† |
| Peak PRA level | |||||
| <10 | Reference | Reference | Reference | Reference | Reference |
| 10–79 | 0.84 (0.75–0.94)† | 0.92 (0.80–1.06) | 0.95 (0.80–1.12) | 0.91 (0.76–1.10) | 0.86 (0.75–0.99)* |
| >=80 | 0.58 (0.49–0.70)‡ | 0.80 (0.65–0.99)* | 0.61(0.47–0.78)‡ | 0.51(0.38–0.69)‡ | 0.77 (0.63–0.93)† |
| Missing | 0.99 (0.78–1.27) | 0.82 (0.60–1.11) | 0.58 (0.39–0.87)† | 0.89 (0.59–1.34) | 0.80 (0.59–1.09) |
| BMI | |||||
| Under weight | 1.12 (0.92–1.38) | 1.03 (0.80–1.32) | 0.82 (0.59–1.12) | 1.20 (0.85–1.68) | 0.97 (0.75–1.26) |
| Normal weight | Reference | Reference | Reference | Reference | Reference |
| Over weight | 1.00 (0.90–1.12) | 0.90 (0.79–1.03) | 0.93 (0.80–1.08) | 1.02 (0.87–1.20) | 1.05 (0.93–1.18) |
| Obese | 0.96 (0.87–1.08) | 0.85 (0.74–0.97)* | 0.84 (0.71–0.99)* | 0.98 (0.82–1.16) | 1.02 (0.90–1.16) |
| Missing | 0.96 (0.59–1.56) | 0.85 (0.46–1.58) | 0.65 (0.27–1.60) | 0.72 (0.28–1.84) | 0.92 (0.52–1.62) |
| Hypertension | 1.03 (0.93–1.14) | 0.91 (0.80–1.03) | 0.95 (0.81–1.10) | 0.98 (0.83–1.15) | 0.90 (0.80–1.01) |
| Highest level of education | |||||
| Grade school | 1.04 (0.86–1.26) | 0.94 (0.74–1.19) | 0.87 (0.65–1.16) | 0.92 (0.68–1.23) | 0.88 (0.69–1.12) |
| High school | 0.96 (0.87–1.05) | 0.87 (0.77–0.98)* | 1.00 (0.86–1.15) | 0.98 (0.83–1.14) | 1.02 (0.91–1.14) |
| College & higher | Reference | Reference | Reference | Reference | Reference |
| Unknown | 0.98 (0.86–1.13) | 0.99 (0.84–1.17) | 1.08 (0.89–1.33) | 0.91 (0.73–1.14) | 1.20(1.02–1.40)* |
| Transplant year | |||||
| 2005 | Reference | Reference | Reference | Reference | Reference |
| 2006 | 0.85 (0.74–0.97)* | 0.83 (0.71–0.97)* | 0.53 (0.44–0.63)‡ | 0.56 (0.46–0.67)‡ | 0.86 (0.74–0.99)* |
| 2007 | 0.86 (0.75–0.98)* | 0.72 (0.61–0.85)‡ | 0.35 (0.29–0.42)‡ | 0.44 (0.36–0.54)‡ | 0.73 (0.62–0.85) |
| 2008 | 0.97 (0.84–1.12) | 0.87 (0.73–1.03) | 0.31 (0.25–0.39)‡ | 0.40 (0.32–0.50)‡ | 0.85 (0.72–1.00) |
| 2009 | 0.97 (0.83–1.14) | 0.92 (0.76–1.11) | 0.29 (0.23–0.37)‡ | 0.34 (0.26–0.44)‡ | 0.98(0.82–1.17) |
| Female Donor | 0.94 (0.86–1.02) | 1.03 (0.93–1.14) | 1.05 (0.93–1.19) | 0.97 (0.85–1.11) | 1. 01(0.92–1.12) |
| Donor type | |||||
| SCD | Reference | Reference | Reference | Reference | Reference |
| ECD | 0.88 (0.75–1.03) | 1.12 (0.94–1.34) | 1.73 (1.40–2.13)‡ | 0.94 (0.74–1.18) | 1.17 (0.98–1.40) |
| LRD | 1.34 (1.19–1.51)‡ | 0.89 (0.77–1.03) | 1.16 (0.98–1.39) | 0.98 (0.81–1.19) | 1.11 (0.97–1.28) |
| LUD | 1.01 (0.89–1.17) | 0.86 (0.73–1.01) | 0.95 (0.78–1.17) | 0.75(0.60–0.94)† | 0.99 (0.84–1.15) |
| Donor race | |||||
| White | Reference | Reference | Reference | Reference | Reference |
| Black | 0.98 (0.85–1.13) | 1.07 (0.90–1.26) | 0.96 (0.78–1.17) | 1.06 (0.83–1.35) | 1.01 (0.86–1.19) |
| Other | 1.01 (0.89–1.15) | 1.27 (1.09–1.48)† | 0.89 (0.73–1.08) | 1.07 (0.88–1.31) | 1.00 (0.86–1.16) |
| Pharmacy Payer | |||||
| Cash | 1.43 (1.18–1.74)‡ | 1.73 (1.37–2.20)‡ | 1.11 (0.82–1.50) | 1.00 (0.75–1.33) | 1.69 (1.36–2.09)‡ |
| Medicaid | 1.18 (0.98–1.42) | 0.92 (0.73–1.17) | 0.75 (0.57–0.99)* | 0.91 (0.67–1.25) | 0.70 (0.54–0.91)† |
| Third Party | 1.07 (0.97–1.18) | 1.34 (1.19–1.51)‡ | 1.13 (0.98–1.30) | 1.03 (0.88–1.21) | 1.25 (1.12–1.40)‡ |
| Induction depletion | 1.42(1.26–1.60)‡ | 1.23(1.07–1.42)† | 1.21(1.01–1.45)* | 0.88(0.73–1.07) | 1.01 (0.88–1.16) |
| Induction IL2R | 0.83(0.73–0.96)† | 0.85(0.72–0.99)* | 1.13(0.93–1.37) | 1.05(0.85–1.29) | 1.21(1.05–1.41)† |
| Acute Rejection | 0.39 (0.32–0.47) ‡ | 0.92 (0.76–1.11) | 1.09 (0.88–1.35) | 0.64(0.49–0.83) † | 1.08 (0.91–1.28) |
P-values:
*
P 0.02–0.04;
†
P 0.0001–0.01;
‡
P < 0.0001