Gender Differences in Liver Transplantation Outcomes in Polycystic Liver Disease.

Abstract

In this study, our objective was to determine gender differences in the outcomes of patients with PLD undergoing liver (LT) or liver/kidney transplantation (SLK). We analyzed the UNOS datasets of all adults who had transplanted for PLD between 1988 and 2018. During the study period, 663 LT/SLK (51% LT only and 49% SLK) were done for PLD patients and of these 500 (75%) were in women. Women were younger (52.8 vs. 56.7years, p < 0.001), had lower MELD at transplant (16.6 vs. 19.4, p < 0.001), had higher serum albumin (3.7 vs. 3.5, p < 0.001), and had alower CTP class (p < 0.008). During the follow-up, 18% (n = 89)women and 29% (n = 47)men died (p = 0.002). Kaplan-Meier (KM)survival estimates showed similar survival rate for patients who had LT and SLK (p = 0.459), but survival rate was significantly higher for womencompared to men (p < 0.001). Multivariable analysis showed that female gender (aHR 0.54, 95% CI 0.33-0.90) was associated with alower mortality. Moreover, Karnofsky Performance Status was excellent for 70% of women and 55% of men (p = 0.03) after LT. Women had better survival whether they received liver or SLK. The era of transplant, whether they were transplanted with MELD exception points or whether they were on dialysis at the time of transplant, did not have an effect on the gender differences in outcomes. Women had 46% lower risk of mortality after adjusting for other covariates compared to men after LT/SLK for PLD.