The Impact of Gender Discordance on Graft Survival Among Liver Transplant Recipients.
Johns Hopkins School of Medicine, Baltimore.
Meeting: 2016 American Transplant Congress
Abstract number: B249
Keywords: Allocation, Graft acceptance, Liver transplantation
Session Information
Session Name: Poster Session B: Liver: MELD, Allocation and Donor Issues (DCD/ECD)
Session Type: Poster Session
Date: Sunday, June 12, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Past studies have shown inferior liver graft survival in gender-discordant recipient/donor pairings compared to gender-matched pairings, particularly in male recipients of female donor livers. However, these studies have not adjusted for characteristics of donors and recipients beyond sex.
METHODS: 97,637 deceased-donor liver-only recipients in the SRTR database between 1990-2012 were classified as female-to-female (FF), female-to-male (FM), male-to-female (MF), or male-to-male (MM). Cox regression was used to analyze the association of gender discordance with all-cause graft failure, adjusted for donor, recipient, and transplant characteristics. Data were split at 3 years to assess short- and long-term graft failure.
RESULTS: Compared to men, women had similar risk of short-term graft failure (aHR=1.02, 95% CI 0.99-1.05, p=0.16) but decreased risk of graft failure after three years (aHR=0.87, 95% CI 0.84-0.91, p<0.001). Among female recipients, MF transplantation was associated with increased risk of short-term graft failure compared to FF transplantation (aHR=1.07, 95% CI 1.02-1.12, p=0.001), but no significant change in risk after 3 years (aHR=1.05, 95% CI 0.99-1.11, p=0.13). Among male recipients, FM transplantation was associated with increased short-term risk compared to MM transplantation (aHR=1.08, 95% CI 1.04-1.12, p<0.001), but no increased risk after 3 years (aHR=0.97, 95% CI 0.93-1.02, p=0.23).
Table 1. Multivariate analysis of the association of gender discordance with graft survival.
CONCLUSION: In both sexes, gender-discordant transplants are associated with inferior short-term graft survival compared to gender-concordant transplants but no increased risk after three years. Male graft survival after three years is inferior to that of females regardless of gender concordance.
CITATION INFORMATION: Moore J, Luo X, Massie A, Purnell T, Mogul D, Segev D. The Impact of Gender Discordance on Graft Survival Among Liver Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Moore J, Luo X, Massie A, Purnell T, Mogul D, Segev D. The Impact of Gender Discordance on Graft Survival Among Liver Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/the-impact-of-gender-discordance-on-graft-survival-among-liver-transplant-recipients/. Accessed November 21, 2024.« Back to 2016 American Transplant Congress