Detalle Publicación


Donor/recipient sex mismatch and survival after heart transplantation: only an issue in male recipients? An analysis of the Spanish Heart Transplantation Registry

Autores: Martinez Selles, M.; Almenar, L.; Paniagua Martin, M. J.; Segovia, J.; Delgado, J. F.; Arizon, J. M.; Ayesta, A.; Lage, E.; Brossa, V.; Manito, N.; Perez Villa, F.; Diaz Molina, B.; Rabago Juan Aracil, Gregorio; Blasco Peiro, T.; De la Fuente Galán, L.; Pascual Figal, D.; Gonzalez Vilchez, F.
ISSN: 0934-0874
Volumen: 28
Número: 3
Páginas: 305 - 313
Fecha de publicación: 2015
The results of studies on the association between sex mismatch and survival after heart transplantation are conflicting. Data from the Spanish Heart Transplantation Registry. From 4625 recipients, 3707 (80%) were men. The donor was female in 943 male recipients (25%) and male in 481 female recipients (52%). Recipients of male hearts had a higher body mass index (25.9 +/- 4.1 vs. 24.3 +/- 3.7; P < 0.01), and male donors were younger than female donors (33.4 +/- 12.7 vs. 38.2 +/- 12.3; P < 0.01). No further relevant differences related to donor sex were detected. In the univariate analysis, mismatch was associated with mortality in men (hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.06-1.32; P = 0.003) but not in women (HR, 0.91; 95% CI 0.74-1.12; P = 0.4). A significant interaction was detected between sex mismatch and recipient gender (P = 0.02). In the multivariate analysis, sex mismatch was associated with long-term mortality (HR, 1.14; 95% CI 1.01-1.29; P = 0.04), and there was a tendency toward significance for the interaction between sex mismatch and recipient gender (P = 0.08). In male recipients, mismatch increased mortality mainly during the first month and in patients with pulmonary gradient >13 mmHg. Sex mismatch seems to be associated with mortality after heart transplantation in men but not in women.