Recipient-Donor Sex Combinations and Posttransplant Infections: A Swiss Transplant Cohort Study

Area of Science:

• Transplant Medicine
• Immunology
• Infectious Diseases

Background:

• The influence of recipient-donor sex combinations (RDSCs) on transplant outcomes remains under-investigated.
• Understanding RDSC impact is crucial for optimizing post-transplant care in solid organ transplantation (SOT).

Purpose of the Study:

• To determine if recipient-donor sex combinations (RDSCs) independently affect infectious events in solid organ transplant (SOT) recipients.
• To analyze the association between RDSCs and post-transplant infection risk, graft survival, and rejection.

Main Methods:

• Retrospective cohort study of 5033 adult SOT recipients (heart, kidney, liver, lung) from a national registry (2008-2021).
• Analysis of clinically significant infectious events, graft survival, rejection, and overall survival within the first year post-transplant.
• Organ-specific, risk-factor-adjusted analyses using incidence rate ratios (IRRs) to assess RDSC impact.

Main Results:

• No significant association found between recipient-donor sex mismatch and weighted posttransplant infection risk across heart, kidney, liver, or lung recipients.
• Female kidney recipients exhibited significantly higher infection rates compared to males (IRR: 1.50), mainly attributed to urinary tract infections.
• One-year graft survival, rejection rates, and overall survival were not influenced by recipient-donor sex combinations.

Conclusions:

• Recipient-donor sex combinations (RDSCs) do not appear to influence one-year solid organ transplant infectious outcomes.
• RDSC does not significantly affect graft survival or rejection as exploratory outcomes in SOT recipients.