Table 4. Adjusted Hazard Ratios (aHR) for Post-Heart Transplant Mortality.
We report the aHR (95% CI) associated with Black race in each age category and the aHR for the additional variables that were added for each given model.
| Variables | Model 1* | p-value | Model 2 = Model 1 + college and insurance | p-value | Model 3 = Model 1 + HLA and PRA | p-value | Model 4 = Model 1 + IS | p-value |
|---|---|---|---|---|---|---|---|---|
| Ages 18–30, Black vs. non-Black | 2.05 (1.67–2.51)† | <0.001 | 1.94 (1.58–2.37) | <0.001 | 2.13 (1.72–2.64) | <0.001 | 2.08 (1.69–2.55) | <0.001 |
| In first year post-transplant | 2.30 (1.60–3.31)† | <0.001 | 2.18 (1.51–3.15) | <0.001 | 2.52 (1.70–3.73) | <0.001 | 2.24 (1.52–3.31) | <0.001 |
| After first year post-transplant | 0.84 (0.54–1.29)† | 0.4 | 0.84 (0.54–1.29) | 0.4 | 0.77 (0.49–1.22) | 0.3 | 0.85 (0.54–1.34) | 0.5 |
| Ages 31–40, Black vs. non-Black | 1.53 (1.25–1.89) | <0.001 | 1.45 (1.18–1.79) | <0.001 | 1.55 (1.24–1.93) | <0.001 | 1.59 (1.28–1.98) | <0.001 |
| Ages 41–60, Black vs. non-Black | 1.20 (1.09–1.33) | <0.001 | 1.16 (1.05–1.28) | <0.01 | 1.18 (1.06–1.32) | <0.05 | 1.23 (1.11–1.36) | <0.001 |
| Ages 61–80, Black vs. non-Black | 1.12 (0.97–1.29) | 0.1 | 1.10 (0.95–1.27) | 0.2 | 1.11 (0.95–1.30) | 0.2 | 1.19 (1.03–1.38) | <0.05 |
| College education | 0.90 (0.85–0.96) | <0.01 | ||||||
| Insurance, Medicaid vs. private | 1.28 (1.17–1.41) | <0.001 | ||||||
| Insurance, Medicare vs. private | 1.19 (1.11–1.27) | <0.001 | ||||||
| HLA mismatch (0–1 vs. 2–6 matches) | 1.04 (0.97–1.10) | 0.3 | ||||||
| PRA | 1.002 (1.000–1.003) | <0.05 | ||||||
| Induction IS | ||||||||
| Thymoglobulin vs. none | 1.08 (0.99–1.18) | 0.1 | ||||||
| IL-2 vs. none | 1.12 (1.05–1.20) | <0.01 | ||||||
| Others/multiple vs. none | 0.91 (0.82–1.02) | 0.1 | ||||||
| Maintenance IS | ||||||||
| Steroid | 0.59 (0.53–0.65) | <0.001 | ||||||
| Tacrolimus | 0.70 (0.66–0.76) | <0.001 | ||||||
| Mycophenolate mofetil | 0.59 (0.53–0.64) | <0.001 | ||||||
Model 1 included recipient age, race, interaction term for age and race, sex, body mass index, heart diagnosis, waiting list status, pulmonary arterial pressure, creatinine, bilirubin, diabetes, hypertension, ventilation, VAD/TAH, ECMO, and dialysis; donor age, race, sex, cancer history, INR; ischemic time, high center level volume (≥ 9 heart transplants/year), donor-recipient sex mismatch, era of transplant (2012–2017 vs. 2005–2011), and year of transplantation. A linear combination of regression parameters was used to calculate the adjusted hazard ratios in each age category.
In Model 1, among recipients aged 18–30, Black recipients had a 2.05-fold higher cumulative risk of death compared to non-Black recipients but this risk was time-varying; in the first year post-transplant, there was a 2.30-fold higher risk of death, while after the first year, there was no significant difference in risk of mortality (p=0.4). All other aHRs outside the denoted 2 rows are cumulative risk. HLA=human leukocyte antigen, PRA=panel reactive antigen, IS=immunosuppression at discharge.