Relevance of male-to-female sex mismatch in liver transplantation for primary biliary cirrhosis.

Abstract

BACKGROUND:

Because male-to-female transplantations are related to exposure to H-Y antigen, sex matching may influence the outcomes after liver transplantation for autoimmune diseases. The purpose of this retrospective study was to evaluate the relevance of male-to-female mismatch in liver transplantation for primary biliary cirrhosis (PBC).

MATERIAL AND METHODS:

This retrospective study was based on the data of 82 female liver transplant recipients with PBC from a single institution. The primary outcome measure was graft survival at 10 years. The negative effects of well-known risk factors for poor outcomes were evaluated separately and compared between the female-to-female and male-to-female transplantations.

RESULTS:

Graft survival was similar after female-to-female and male-to-female transplantations (74.7% versus 73.1% at 10 years, respectively, p=0.676). Regarding the differential impact of other risk factors, prolonged cold ischemia and increased amount of blood transfusions adversely influenced outcomes after male-to-female transplantation (p=0.039 and p=0.039, respectively) but not after female-to-female transplantation (p=0.843 and p=0.110, respectively). Sex mismatched transplantations were associated with lower 10-year graft survival in subgroups of patients with blood transfusions >4 units (61.4% versus 100.0%, p=0.063) and >8 hours of cold ischemia (54.7% versus 75.8%, p=0.418).

CONCLUSIONS:

Although male-to-female sex mismatch does not seem to yield a direct negative impact on outcomes following liver transplantation for PBC, it can aggravate the negative effects of prolonged cold ischemia and blood transfusions.

• Authors: Michał Grąt, Zbigniew Lewandowski, Waldemar Patkowski, Karolina Maria Wronka, Karolina Grąt, Maciej Krasnodębski, Joanna Ligocka, Hanna Zborowska, Marek Krawczyk
• Journal: Annals of transplantation (Ann Transplant) Vol. 20 Pg. 116-23 (Mar 02 2015) ISSN: 2329-0358 [Electronic] United States
• PMID: 25728977 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aged
• Child
• Donor Selection
• Female
• Graft Rejection (etiology)
• Graft Survival
• Humans
• Liver Cirrhosis, Biliary (surgery)
• Liver Transplantation
• Male
• Middle Aged
• Retrospective Studies
• Risk Factors
• Sex Factors
• Young Adult