Influence of donorrecipient gender mismatch on graft function and survival following lung transplantation

Author： Alvarez Antonio Moreno Paula Illana Jennifer Espinosa Dionisio Baamonde Carlos Arango Elisabet Algar Francisco Javier Salvatierra Angel

Publisher： Oxford University Press

ISSN： 1569-9293

Source： Interactive CardioVascular and Thoracic Surgery, Vol.16, Iss.4, 2013-04, pp. : 426-435

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Abstract

OBJECTIVESIn current practice, donors and recipients are not matched for gender in lung transplantation. However, some data have suggested a possible effect of gender combinations on lung transplant outcomes. We examined whether donorrecipient (D/R) gender mismatch is related to adverse outcomes after lung transplantation in terms of early and long-term graft function and survival.METHODSWe reviewed 256 donors and lung transplant recipients over a 14-year period. Patients were distributed into four groups: Group A (D/R: female/female), Group B (D/R: male/male), Group C (D/R: female/male), Group D (D/R: male/female). Donor and recipient variables were compared among groups, including early graft function, 30-day mortality, freedom from bronchiolitis obliterans syndrome (BOS), and long-term survival.RESULTSGroup A: 57 (22), Group B: 99 (39), Group C: 62 (24), Group D: 38 (15) transplants (P 0.001). Donor age was 29 14, 27 12, 33 13 and 23 12 years for Groups A, B, C and D, respectively (P 0.004). Recipient age was 31 15, 44 17, 42 16 and 30 16 years for Groups A, B, C and D, respectively (P 0.000). PaO₂/FiO₂ (mmHg) 24 h post-transplant was: Group A: 276 144, Group B: 297 131, Group C: 344 133 and Group D: 238 138 (P 0.015). Primary graft dysfunction developed in 23, 14, 17 and 21 of recipients from Groups A, B, C and D, respectively (P 0.45). Operative mortality was 4.4, 6.5, 5.2 and 2, for recipients from Groups A, B, C and D, respectively (P 0.66). Freedom from BOS was 73, 59 and 36 for gender-matched transplants vs 76, 67 and 40 for gender-mismatched transplants at 3, 5 and 10 years, respectively (P 0.618), without differences among groups. A non-significant survival benefit was observed for female recipients, irrespective of the donor gender.CONCLUSIONSDonorrecipient gender mismatch does not have a negative impact on early graft function and mortality following lung transplantation. There is a trend towards a survival benefit for female recipients, irrespective of the donor gender.