Purpose: Through several registries, it has been found that gender mismatch, female donor-to-male recipient (F/M) compared to male donor-to-male recipient (M/M) has lower survival. These findings may relate to the development of antibodies against H-Y antigens (from the male Y chromosome), size mismatch or force of contraction mismatch.

Methods: Between 1987 and 2013 we assessed 37,889 heart transplant patients in the UNOS database in regard to gender matching. Patients were divided into groups depending on recipient age: Group A (18-30 years), Group B (31-50 years) and Group C (>50 years) with 3 year survival calculated according to gender mismatch F/M vs M/M.

Results: F/M recipient gender mismatch had significantly lower 3-year survival compared to M/M for Group B and Group C. However, there was no significant difference in 3-year survival for both F/M and M/M donor-to-recipient groups aged 18-30 at the time of transplant.

Conclusions: Heart transplant patients with F/M recipient gender mismatch (compared to M/M) have significantly lower survival except in heart transplant patients ages 18-30. Gender mismatch does not appear to be a mortality risk in younger heart transplant patients. Further investigation into this observation is warranted.

CITATION INFORMATION: Kobashigawa J, Kittleson M, Czer L, Aintablian T, Passano E, Chang D, Esmailian F, Patel J. Gender Mismatch in the UNOS Heart Transplant Database: Not a Factor in Younger Heart Transplant Patients. Am J Transplant. 2016;16 (suppl 3).

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