Effect of Donor-Recipient Sex Mismatch on the Outcome of Simultaneous Pancreas-Kidney Transplant.

Abstract

There have been conflicting reports detailing the effect of sex match between transplant donor and recipient on the outcome of solid-organ transplants. We investigated the effect of donor-recipient sex match on allograft function and survival outcomes after simultaneous pancreas-kidney transplant at a single transplant center in China. We retrospectively reviewed data for 120 simultaneous pancreas-kidney transplant recipients treated at our center during the period from January 2015 to January 2020. Patients were divided into a sex-matched group (n = 88) and a sex-mismatched group (n = 32). Kidney and pancreatic allograft function and survival outcomes were compared between the 2 groups. Propensity score matching was used to enhance the comparability of the study participants. After propensity score matching, 24 patients were included in the sex-matched group, and 24 patients were in the sex-mismatched group. The median follow-up duration was 23 months. Before propensity score matching, pancreatic allograft death-censored survival rates at 1 year and 3 years were 94.30% and 92.90% in the sex-matched group and 100% and 100% in the sex-mismatched group, respectively. However, after propensity score matching, there was a further reduction in pancreatic allograft death-censored survival in the sex-matched group. At follow-up, the pancreas allograft death-censored survival rate was significantly less in the sex-matched group versus the sex-mismatched group (after propensity score matching; P = .042). For other parameters, such as estimated glomerular filtration rate, fasting blood glucose, glycated hemoglobin, allograft rejection, patient survival, and kidney allograft death-censored survival, there were no significant differences between the sex-matched and sex-mismatched groups. Donor-recipient sex match significantly reduced pancreatic allograft survival, indicating that more attention should be focused on sex-matched recipients for development of donor allocation and postoperative monitoring strategies.