Influence of Donor and Recipient Sex Matching on Simultaneous Pancreas-kidney Transplantation Outcomes

Abstract

Purpose: The objective was to analyze the influence of the sex matching between donor and recipient in the overall survival and the SPK grafts survival in our center. Methods: We conducted a retrospective analysis on a prospective database of SPK transplants performed between February 1989 and June 2019 at a regional referral center (n = 199). SPSS v22 was used for the statistical analysis, considering a value of p <0.05 to be statistically significant. Results: Of the 199 recipients, 148 (74.4%) were men. In the donor group 131 (65.8%) were men. In 91 patients (47.5%) there was a sex mismatch between donor and recipient. The median follow-up time was 117 months (range 0-337).Overall survival (OS) was 93.5% at 5 years, 84.3% at 10 years, and 71.5% at 15 years. In the group with sex mismatch, OS at 5, 10 and 15 years was 94%, 82.3% and 71.7% compared to 92.3%, 85.1% and 72.2% in the sex matched group, not finding statistically significant differences (p = 0.86). Graft survival, censored for patient death of the pancreatic (dcPGS) and renal (dcKGS) at 5, 10 and 15 years were 78.5%, 64.9% and 62.3% in the pancreatic graft and 90%, 84, 9% and 79.8% in the kidney graft. In the sub-analysis dcPGS at 5, 10 and 15 years was 79.5%, 60.8% and 57.5% in the group with sex mismatch compared to 77.5%, 67.8% and 65.5% in the sex matched group (P = 0.54). dcKGS at 5, 10 and 15 years was 89.3%, 85% and 78.1% in the group with sex mismatch compared to 87.3%, 83.5% and 78.8% in the other group (P = 0.69). No differences were observed between the two groups in terms of postoperative complications or acute rejection. Conclusion: Our study shows that sex mismatch between donor and recipient in SPK transplantation does not negatively influence perioperative results, graft survival or patient survival. Currently, SPK transplantation with sex mismatch is a safe practice that must continue to compensate for pancreas grafts shortage.