Table 1.
Distributions of clinical traits in the study samples of Medicare-insured transplant recipients according to CDOA.
| 1-Year Pretransplant Assessment | 1-Year Posttransplant Assessment | |||||
|---|---|---|---|---|---|---|
| No CDOA (n=52,435) |
CDOA (n=254) |
Adjusted odds ratio | No CDOA (n=50,498) |
CDOA (n=163) |
Adjusted odds ratio | |
| Age (years) | ‡ | ‡ | ||||
| ≤18 | 2.1 | 1.2 | 0.26 (0.07-0.95) * | 4.2 | 8.0 | 0.68 (0.25-1.84) |
| 19-30 | 6.4 | 20.9 | Reference | 7.2 | 23.9 | Reference |
| 31-44 | 18.2 | 33.9 | 0.63 (0.44-0.90) * | 17.9 | 26.4 | 0.45 (0.28-0.71) † |
| 45-59 | 35.3 | 38.6 | 0.37 (0.26-0.54) ‡ | 36.7 | 34.4 | 0.30 (0.19-0.49) ‡ |
| ≥60 | 37.9 | 5.5 | 0.05 (0.03-0.09) ‡ | 34.0 | 7.4 | 0.08 (0.04-0.16) ‡ |
| Male | 61.2 | 76.4‡ | 2.23 (1.64-3.03) ‡ | 60.7 | 77.3‡ | 2.33 (1.58-3.42) ‡ |
| Race | ‡ | ‡ | ||||
| White | 47.2 | 36.6 | Reference | 52.3 | 31.3 | Reference |
| Black | 31.6 | 48.8 | 1.38 (1.02-1.85) * | 27.9 | 52.8 | 2.07 (1.40-3.06) † |
| Hispanic | 14.6 | 13.4 | 0.75 (0.50-1.12) | 13.6 | 12.3 | 0.85 (0.50-1.44) |
| Other | 6.7 | 1.2 | 0.17 (0.05-0.54) * | 6.3 | 3.7 | 0.76 (0.32-1.81) |
| BMI (kg/m2) | ‡ | † | ||||
| <18.5 | 2.8 | 2.4 | 0.61 (0.26-1.42) | 3.6 | 8.6 | 1.68 (0.87-3.24) |
| 18.5-24.9 | 27.3 | 41.7 | Reference | 27.2 | 36.8 | Reference |
| 25-30 | 32.2 | 32.7 | 0.76 (0.57-1.02) | 31.9 | 28.8 | 0.82 (0.55-1.21) |
| >30 | 34.9 | 22.4 | 0.45 (0.32-0.63) ‡ | 34.3 | 23.9 | 0.61 (0.40-0.93) * |
| Unknown | 2.9 | 0.8 | 0.20 (0.05-0.81) * | 3.1 | 1.8 | 0.52 (0.16-1.68) |
| Cause of ESRD | ‡ | * | ||||
| Diabetes | 27.1 | 16.5 | 1.02 (0.54-1.91) | 25.6 | 18.4 | 3.69 (1.11-12.29) * |
| Glomerulonephritis | 20.8 | 28.7 | 1.14 (0.81-1.62) | 21.4 | 27.6 | 1.13 (0.72-1.77) |
| Hypertension | 29.4 | 34.7 | Reference | 27.5 | 31.9 | Reference |
| Polycystic kidney disease | 7.6 | 3.5 | 0.62 (0.30-1.26) | 9.7 | 4.9 | 0.99 (0.45-2.16) |
| Other | 15.2 | 16.5 | 1.03 (0.68-1.58) | 15.8 | 17.2 | 1.00 (0.57-1.75) |
| Dialysis duration (months) | * | ‡ | ||||
| None | 6.7 | 3.5 | 1.59 (0.76-3.34) | 14.5 | 5.5 | 0.78 (0.37-1.63) |
| >0-24 | 21.4 | 14.6 | Reference | 30.5 | 24.5 | Reference |
| 25-60 | 41.5 | 41.3 | 1.20 (0.82-1.75) | 34.5 | 30.7 | 0.99 (0.63-1.57) |
| >60 | 29.7 | 39.8 | 1.31 (0.88-1.94) | 19.7 | 39.3 | 1.82 (1.13-2.93) * |
| Missing | 0.7 | 0.8 | 2.06 (0.49-8.69) | 0.9 | 0.0 | NA |
| Comorbid conditions | ||||||
| Diabetes | 36.8 | 22.1‡ | 0.79 (0.45-1.39) | 34.1 | 20.25† | 0.29 (0.09-0.92) * |
| Angina | 7.3 | 6.7 | 1.41 (0.84-2.36) | 7.0 | 4.3 | 0.84 (0.38-1.83) |
| COPD | 1.4 | 1.2 | 1.30 (0.41-4.14) | 1.2 | 2.5 | 3.50 (1.26-9.73) * |
| Hypertension | 81.0 | 83.1 | 1.08 (0.76-1.55) | 80.1 | 81.0 | 1.11 (0.72-1.72) |
| Cerebral vascular disease | 2.9 | 2.0 | 0.81 (0.33-2.00) | 2.7 | 1.2 | 0.57 (0.14-2.36) |
| Peripheral vascular disease | 4.3 | 2.4 | 0.77 (0.33-1.77) | 3.9 | 2.5 | 0.92 (0.33-2.57) |
| Education level | ‡ | ‡ | ||||
| College & higher | 43.5 | 31.1 | Reference | 44.1 | 20.9 | Reference |
| Grade/High schools | 46.9 | 61.0 | 1.51 (1.14-1.99) * | 45.1 | 67.5 | 2.38 (1.60-3.55) ‡ |
| Unknown | 9.6 | 7.9 | 1.11 (0.67-1.84) | 10.9 | 11.7 | 1.85 (1.03-3.31) * |
| Employment | * | † | ||||
| Working | 19.3 | 11.8 | 0.46 (0.31-0.67) ‡ | 26.9 | 13.5 | 0.47 (0.29-0.75) * |
| Not working | 70.3 | 80.7 | Reference | 60.5 | 73.0 | Reference |
| Unknown | 10.4 | 7.5 | 0.57 (0.34-0.95) * | 12.5 | 13.5 | 0.45 (0.22-0.90) * |
| Physical capacity | ||||||
| No limit | 65.1 | 67.7 | Reference | 64.8 | 63.2 | Reference |
| Limited | 8.1 | 7.9 | 1.06 (0.66-1.71) | 7.5 | 4.9 | 0.70 (0.34-1.47) |
| Unknown | 26.8 | 24.4 | 0.94 (0.70-1.27) | 27.7 | 31.9 | 1.13 (0.78-1.63) |
| Previous transplant | 14.3 | 11.4 | 0.45 (0.29-0.72) † | 2.6 | 0.6 | 0.31 (0.04-2.33) |
| Most Recent PRA | ||||||
| 0-9 | 68.3 | 70.1 | Reference | 77.5 | 79.8 | Reference |
| 10-79 | 19.0 | 19.3 | 1.16 (0.83-1.63) | 15.8 | 13.5 | 0.98 (0.62-1.56) |
| ≥80 | 7.7 | 7.9 | 1.31 (0.76-2.23) | 4.0 | 2.5 | 0.89 (0.31-2.52) |
| Missing | 5.0 | 2.8 | 0.66 (0.31-1.43) | 2.7 | 4.3 | 2.13 (0.97-4.67) |
| HLA mismatch | ||||||
| Zero A, B, DR | - | - | - | 7.1 | 4.9 | 0.98 (0.47-2.05) |
| Zero DR | - | - | - | 10.7 | 10.4 | 1.02 (0.61-1.70) |
| Other | - | - | - | 82.2 | 84.7 | Reference |
| Donor type | * | |||||
| Living | - | - | - | 35.0 | 25.8 | 1.00 (0.60-1.65) |
| SCD | - | - | - | 44.4 | 52.8 | Reference |
| ECD | - | - | - | 11.2 | 6.8 | 0.95 (0.49-1.82) |
| DCD | - | - | - | 9.4 | 14.7 | 1.37 (0.86-2.18) |
| Year of transplant | ||||||
| 2007-2010 | 33.7 | 31.9 | Reference | 61.0 | 57.1 | Reference |
| 2011-2015 | 66.3 | 68.1 | 1.14 (0.87-1.50) | - | - | - |
| 2011-2013 | - | - | - | 39.0 | 42.9 | 1.09 (0.79-1.50) |
Abbreviations: BMI, body mass index; CDOA, cannabis dependence or abuse; COPD, chronic obstructive pulmonary disease; DCD, donation after circulatory death; ECD, extended criteria donor; ESRD, end-stage renal disease; HLA, human leukocyte antigen; NA, not applicable; PRA, panel reactive antibody; SCD, standard criteria donor.
P values:
*
P < 0.05–0.002;
†
P = 0.001–0.0001;
‡
P < 0.0001, for differences of distributions of clinical traits among patients with versus without CDOA.
“Other race” includes Asian, Native American, Pacific Islander and multiracial.