Impact of Gender Matching in Heart Transplantation: Does Sex Matter?

Abstract

Purpose Appropriate allocation of suitable donor organs has a major impact on outcome after Heart transplantation (HTx). In contrast to body weight and height matching of respective donor and recipient, gender mismatch remains a matter of discussion. Particularly, gender-related differences in sex hormones and immunological processes that may impact the outcome after HTx are still not fully understood. Methods Between 2010 and 2020 a total of 178 patients underwent HTx in our department. The patients could be divided into four groups according to gender matching (male donor for male recipient: MDMR group, n=92; male for female: MDFR group, n=9; female for male: FDMR group, n=42; female for female: FDFR group, n=35). Results The groups were comparable regarding, age, underlying disease, graft function and allograft ischemia, but recipients of male donor organs were significantly more often listed with high urgency (HU) status. In addition, height (p 1R). Hospitalization time, stay on intensive care unit and duration of mechanical ventilation did not differ either. However, there was a slight trend towards impaired 30-day survival (MDMR group: 91.0%, MDFRgroup: 100%, FDMR group: 92.9%, FDFR group: 76.5%, p=0.09) and one-year (MDMR group: 83.3%, MDFR group: 62.5%, FDMRgroup: 74.4%, FDFR group: 77.1%, p=0.22) survival of female recipients compared to male ones. Conclusion We did not find any significant differences in outcome after HTx related to gender matching of donors and recipients. However, there was a trend towards impaired early survival for female recipients. This effect was irrespective of the donor's gender. Our results indicate that sex does not matter for the outcome after HTx. Therefore, we suggest mainly to focus on our parameters such as size and weight matching instead of gender in order to achieve the best results for all patients undergoing HTx.