Analysis of the impact of donor gender on early mortality

Many studies have shown a detrimental effect of female donor gender on heart transplantation (HT) outcome.

We retrospectively evaluated our experience in HT to determine the effect of donor gender on early survival.

We divided the sample of 464 primary HT from November 1997 to September 2006 into 4 groups: G1, female donor to a male recipient; G2, male donor to a male recipient; G3, male donor to female recipient; and G4, female donor to a female recipient. We performed a descriptive study of the baseline characteristics. The chi(2) test was used to determine differences in early mortality (30 days) between groups and a multivariate analysis to identify confounding factors to increase mortality.

Although the univariate study showed that G1 showed a significantly lower early survival rate (84%) than G2 (91%), the multivariate study adjusted for donor and recipient weight and size, urgency level, previous surgery, and age only showed urgency level (odds ratio [OR] 2.6; 95% confidence interval [CI] 1.2-5.57; P = .016) and previous surgery (OR 5.8; 95% CI 2.7-12.4; P < .01) to be predictors of early mortality. When baseline characteristics were analyzed, we found that 31% of HT in G1 were urgent versus 18% in G2, and 32% of patients in G1 had previous surgery versus 17% in G2.

Donor gender did not appear to negatively affect early survival. In our series, urgent HT in male recipients with a female was more frequent than with a male donor heart. The higher early mortality in male recipients of an urgent HT from a female than from a male donor was attributable to a higher baseline risk profile.