Impact of donor–recipient sex match on long‐term survival after heart transplantation in children: An analysis of 5797 pediatric heart transplants. (22nd December 2015)

• Record Type: Journal Article
• Authors: Kemna, Mariska; Albers, Erin; Bradford, Miranda C.; Law, Sabrina; Permut, Lester; McMullan, D. Mike; Law, Yuk
• Is Part Of: Pediatric transplantation. Volume 20:Number 2(2016:Mar.)
• Page Start: 249
• Page End: 255
• Publication Date: 2015-12-22
• Subjects: pediatric -- heart transplantation -- graft survival -- long‐term results; Transplantation of organs, tissues, etc. in children -- Periodicals; 617.95408305
• DOI: 10.1111/petr.12649
• Languages: English
• ISSNs: 1397-3142

Abstract

Abstract: The effect of donor–recipient sex matching on long‐term survival in pediatric heart transplantation is not well known. Adult data have shown worse survival when male recipients receive a sex‐mismatched heart, with conflicting results in female recipients. We analyzed 5795 heart transplant recipients ≤18 yr in the Scientific Registry of Transplant Recipients (1990–2012). Recipients were stratified based on donor and recipient sex, creating four groups: MM (N = 1888), FM (N = 1384), FF (N = 1082), and MF (N = 1441). Males receiving sex‐matched donor hearts had increased unadjusted allograft survival at five yr (73.2 vs. 71%, p = 0.01). However, this survival advantage disappeared with longer follow‐up and when adjusted for additional risk factors by multivariable Cox regression analysis. In contrast, for females, receiving a sex‐mismatched heart was associated with an 18% higher risk of allograft loss over time compared to receiving a sex‐matched heart (HR 1.18, 95% CI: 1.00–1.38) and a 26% higher risk compared to sex‐matched male recipients (HR 1.26, 95% CI: 1.10–1.45). Females who receive a heart from a male donor appear to have a distinct long‐term survival disadvantage compared to all other groups.