Grant support: this project was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (T32 DK060414, JCL) and the University of California San Francisco Liver Center (JCL, NAT).
Gender Differences in Liver Donor Quality Are Predictive of Graft Loss
Article first published online: 10 JAN 2011
©2011 The Authors Journal compilation©2011 The American Society of Transplantation and the American Society of Transplant Surgeons
American Journal of Transplantation
Volume 11, Issue 2, pages 296–302, February 2011
How to Cite
Lai, J. C., Feng, S., Roberts, J. P. and Terrault, N. A. (2011), Gender Differences in Liver Donor Quality Are Predictive of Graft Loss. American Journal of Transplantation, 11: 296–302. doi: 10.1111/j.1600-6143.2010.03385.x
- Issue published online: 27 JAN 2011
- Article first published online: 10 JAN 2011
- Received 13 September 2010, revised 13 September 2010 and accepted for publication 11 October 2010
- Donor age;
- donor risk index;
- gender mismatch
Some studies have found that donor–recipient gender mismatch predicts posttransplant outcomes but whether this is independent of donor quality is unknown. To evaluate the association between gender mismatch and graft loss, 11 508 females (F) and 16 714 males (M) who underwent liver transplant from March 1, 2002 to December 31, 2007 were studied. Of 11 donor characteristics, clinically relevant differences between F and M donors were median age (47 vs. 39 years), height (165 vs. 178 cm) and proportion dying of stroke (59 vs. 35%) (p < 0.001 for all). The donor risk index was significantly lower for F than M donors (1.3 vs. 1.6, p < 0.001). Recipients of gender-mismatched grafts had an 11% higher risk of graft loss (p < 0.001). Compared to MM donor–recipient-matched transplants in univariable analysis, FM mismatch was associated with a 17% increased risk of graft loss (95% CI = 1.11–1.24, p < 0.001), whereas MF mismatch was not (HR = 1.02; 95% CI = 0.96–1.09; p = 0.46). However, adjustment for significant recipient and donor factors eliminated the association between FM mismatch and graft loss (HR = 0.95; 95% CI = 0.89–1.02; p = 0.18). In conclusion, donor quality differs significantly between female and male donors—female donors are older, shorter and die more frequently of stroke—and gender differences in donor quality, rather than gender mismatch are predictive of graft loss.