Abstract
To assess the role of sex mismatch on graft survival after pancreas transplantation. We evaluated 24,195 pancreas-transplant recipients reported in the Scientific Registry of Transplant Recipients over a 25-year period. Pancreatic graft survival (PGS) was analyzed according to donor–recipient sex pairing using Kaplan–Meier estimations. Hazard ratios were estimated using Cox proportional hazard models. A total of 14,187 male and 10,008 female recipients were included in final analyses. Mean follow-up was 8.3 ± 5.7 years. In multivariate analyses, neither recipient sex nor donor sex was associated with pancreatic graft failure (PGF), but donor–recipient sex mismatch (regardless of recipient sex) was an independent predictor of PGS (HR, 1.09; 95% CI, 1.04–1.14; p < 0.001). Compared with M → M sex-matched recipients in univariate analyses, M → F and F → M sex mismatches were associated with an increased risk of PGF. Adjustment for significant recipient and donor factors eliminated the association between F → M sex mismatch and PGF (HR, 1.02; 95% CI, 0.93–1.10; p = 0.752), but not M → F (1.09; 1.02–1.17; 0.020). Stratified analyses suggested that the negative effect of donor–recipient sex mismatch could be neutralized in older patients. These findings suggest that donor–recipient sex pairing should be taken into consideration in organ-allocation strategies.
Highlights
To assess the role of sex mismatch on graft survival after pancreas transplantation
The present study is the first to show that neither donor sex nor recipient sex is associated with pancreatic graft failure (PGF) in multivariate analyses, but that donor–recipient sex mismatch is associated with PGF in all types of pancreas transplantation
Further stratified analyses demonstrated that male donor to a female recipient (M →F) mismatch is an independent predictor of PGF, and that other risk factors are: young recipients; a high Pancreas Donor Risk Index (PDRI), pancreas after kidney transplantation” (PAK) or pancreas transplantation alone” (PTA); overweight recipients
Summary
To assess the role of sex mismatch on graft survival after pancreas transplantation. We evaluated 24,195 pancreas-transplant recipients reported in the Scientific Registry of Transplant Recipients over a 25-year period. Neither recipient sex nor donor sex was associated with pancreatic graft failure (PGF), but donor–recipient sex mismatch (regardless of recipient sex) was an independent predictor of PGS (HR, 1.09; 95% CI, 1.04–1.14; p < 0.001). Several reports on liver transplantation have shown that recipients with sex-mismatched donors have an increased risk of graft failure compared with those with sex-matched donors[6,7,8,9]. A study from Norway confirmed recipient sex not to be associated with pancreatic graft survival (PGS) or patient survival[12]. All of these reports looked only at the impact of donor sex or recipient sex. Using a large national registry database, we sought to clarify and quantify the influence of donor–recipient sex pairing on the outcomes of pancreas transplantation
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
