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Influence of recipient and donor gender on outcome after heart transplantation
A Fabbri1, A J Bryan, L D Sharples
1Cattedra di Cardiochirurgia, University of Verona, Italy.
Insights
Donor gender significantly impacts heart transplant outcomes, with female donors linked to higher early mortality and acute rejection rates in recipients. Recipient gender did not show a significant effect on overall survival.
Area of Science:
- Cardiology
- Transplantation Immunology
- Medical Statistics
Background:
- Heart transplantation is a life-saving procedure for end-stage heart failure.
- Understanding factors influencing transplant outcomes is crucial for improving patient survival.
- Recipient and donor characteristics, including gender, may play a role in transplant success.
Purpose of the Study:
- To examine the influence of recipient and donor gender on outcomes following heart transplantation.
- To identify gender-specific differences in early and late mortality, rejection rates, and morbidity.
Main Methods:
- Retrospective analysis of 366 heart transplants performed between 1979 and 1989 at Papworth Hospital.
- Data collected included recipient and donor demographics, early (within 90 days) and late postoperative mortality, and causes of death.
- Statistical analysis compared outcomes based on recipient and donor gender.
Main Results:
- Female recipients had a higher early mortality rate (30%) compared to males (16%), though this difference was not statistically significant overall.
- Fatal acute rejection was significantly more common in female recipients (7/40) than male recipients (19/316).
- Recipients of female donor grafts experienced significantly higher mortality, especially in the early period and due to acute rejection, compared to recipients of male donor grafts.
Conclusions:
- Donor gender, particularly female donors, is associated with increased early mortality and acute rejection after heart transplantation.
- While recipient gender alone did not significantly affect overall survival, female recipients showed a higher incidence of fatal acute rejection.
- These findings highlight the importance of donor-recipient gender matching in heart transplantation to optimize patient outcomes.
Abstract:
To investigate the effect of recipient and donor genders on the outcome after heart transplantation, a retrospective survey was undertaken of 356 patients (366 transplants: 316 males, 40 females) undergoing transplantation between January 1979 and December 31, 1989, at Papworth Hospital. Ninety-three organs came from female donors; 263 organs came from males. Twelve females (30%; 95% confidence interval 16% to 44%) and 51 males (16%; 95% confidence interval 12% to 20%) died in the early postoperative period (within 90 days of operation). To date, two females (5%) and 51 males (16%) have died in the late postoperative period. Comparison between recipient genders showed no statistically significant difference in early mortality rates from any cause or in actuarial survival overall, although fatal acute rejection was significantly more common in female recipients (7 of 40 female recipients versus 19 of 316 male recipients). The higher incidence of fatal rejection among female recipients was related to the higher proportion of female donors in this group, because recipients of female donor grafts had significantly higher mortality rates, particularly in the early postoperative period and as a result of acute rejection, than did recipients of organs from male donors. Death from rejection after the first 3 months and death from infection were not gender-related. Recipients of grafts from female donors did not suffer significantly more early morbidity, such as rejection and infection, or late morbidity in the form of coronary artery disease. Acute rejection episodes were more common in female recipients.(ABSTRACT TRUNCATED AT 250 WORDS)