Differences in Liver Graft Survival by Recipient Sex
Background. We aimed to characterize patterns of differences in liver graft failure rates by recipient sex, accounting for the modifying effects of donor sex and recipient age. Methods. We evaluated 144 212 first deceased donor liver transplant recipients [1988–2019; Scientific Registry of Transplan...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2020-12-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001084 |
| _version_ | 1818656694744383488 |
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| author | Alexia I. De Simone, MSc Xun Zhang, PhD Mourad Dahhou, MSc Ruth Sapir-Pichhadze, PhD Heloise Cardinal, MD Vicky Ng, MD Bethany J. Foster, MD |
| author_facet | Alexia I. De Simone, MSc Xun Zhang, PhD Mourad Dahhou, MSc Ruth Sapir-Pichhadze, PhD Heloise Cardinal, MD Vicky Ng, MD Bethany J. Foster, MD |
| author_sort | Alexia I. De Simone, MSc |
| collection | DOAJ |
| description | Background. We aimed to characterize patterns of differences in liver graft failure rates by recipient sex, accounting for the modifying effects of donor sex and recipient age.
Methods. We evaluated 144 212 first deceased donor liver transplant recipients [1988–2019; Scientific Registry of Transplant Recipients (SRTR)]. We used multivariable time-varying Cox models, considering a recipient sex by donor sex by recipient age (0–12, 13–24, 25–44, ≥45 y) interaction.
Results. Among recipients of male donors, females <45 y had higher graft failure rates than males of the same age, but none of these differences were statistically significant [0–12 y: adjusted hazard ratio (aHR) 1.17 (0.98, 1.40); 13–24 y: aHR 1.18 (0.96, 1.46); 25–44 y: aHR 1.11 (0.96, 1.28)]; there was no material or statistically significant difference between female and male recipients ≥45 y [aHR 1.01 (0.97, 1.06)]. When the donor was female, recipients <45 y showed no statistically significant differences in graft outcomes by recipient sex [0–12 y: aHR 0.91 (0.74, 1.11); 13–24 y: aHR 0.98 (0.77, 1.25); 25–44 y: aHR 0.86 (0.73, 1.01)], whereas female recipients ≥45 y had significantly lower graft failure rates [aHR 0.85 (0.81, 0.89)] than males of the same age.
Conclusions. Among recipients of female donors, female recipients ≥45 y had significantly better outcomes than males of the same age; there were no clear differences by recipient sex in younger recipients. When the donor was male, there was no material or statistically significant difference in graft failure rates between males and females ≥45 y; among younger recipients point estimates suggested higher failure rates in females than males recipients, but confidence intervals were wide making firm conclusions impossible. Larger studies combining multiple datasets are needed. |
| first_indexed | 2024-12-17T03:29:40Z |
| format | Article |
| id | doaj.art-af44cb21dca74c92974be7cbb5b4d2ee |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-12-17T03:29:40Z |
| publishDate | 2020-12-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-af44cb21dca74c92974be7cbb5b4d2ee2022-12-21T22:05:18ZengWolters KluwerTransplantation Direct2373-87312020-12-01612e62910.1097/TXD.0000000000001084202012000-00006Differences in Liver Graft Survival by Recipient SexAlexia I. De Simone, MSc0Xun Zhang, PhD1Mourad Dahhou, MSc2Ruth Sapir-Pichhadze, PhD3Heloise Cardinal, MD4Vicky Ng, MD5Bethany J. Foster, MD61 Faculty of Medicine, McGill University, Montreal, QC, Canada.2 Research Institute of the McGill University Health Centre, Montreal, QC, Canada.2 Research Institute of the McGill University Health Centre, Montreal, QC, Canada.1 Faculty of Medicine, McGill University, Montreal, QC, Canada.5 Department of Pediatrics, McGill University, Montreal, QC, Canada.8 Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada.1 Faculty of Medicine, McGill University, Montreal, QC, Canada.Background. We aimed to characterize patterns of differences in liver graft failure rates by recipient sex, accounting for the modifying effects of donor sex and recipient age. Methods. We evaluated 144 212 first deceased donor liver transplant recipients [1988–2019; Scientific Registry of Transplant Recipients (SRTR)]. We used multivariable time-varying Cox models, considering a recipient sex by donor sex by recipient age (0–12, 13–24, 25–44, ≥45 y) interaction. Results. Among recipients of male donors, females <45 y had higher graft failure rates than males of the same age, but none of these differences were statistically significant [0–12 y: adjusted hazard ratio (aHR) 1.17 (0.98, 1.40); 13–24 y: aHR 1.18 (0.96, 1.46); 25–44 y: aHR 1.11 (0.96, 1.28)]; there was no material or statistically significant difference between female and male recipients ≥45 y [aHR 1.01 (0.97, 1.06)]. When the donor was female, recipients <45 y showed no statistically significant differences in graft outcomes by recipient sex [0–12 y: aHR 0.91 (0.74, 1.11); 13–24 y: aHR 0.98 (0.77, 1.25); 25–44 y: aHR 0.86 (0.73, 1.01)], whereas female recipients ≥45 y had significantly lower graft failure rates [aHR 0.85 (0.81, 0.89)] than males of the same age. Conclusions. Among recipients of female donors, female recipients ≥45 y had significantly better outcomes than males of the same age; there were no clear differences by recipient sex in younger recipients. When the donor was male, there was no material or statistically significant difference in graft failure rates between males and females ≥45 y; among younger recipients point estimates suggested higher failure rates in females than males recipients, but confidence intervals were wide making firm conclusions impossible. Larger studies combining multiple datasets are needed.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001084 |
| spellingShingle | Alexia I. De Simone, MSc Xun Zhang, PhD Mourad Dahhou, MSc Ruth Sapir-Pichhadze, PhD Heloise Cardinal, MD Vicky Ng, MD Bethany J. Foster, MD Differences in Liver Graft Survival by Recipient Sex Transplantation Direct |
| title | Differences in Liver Graft Survival by Recipient Sex |
| title_full | Differences in Liver Graft Survival by Recipient Sex |
| title_fullStr | Differences in Liver Graft Survival by Recipient Sex |
| title_full_unstemmed | Differences in Liver Graft Survival by Recipient Sex |
| title_short | Differences in Liver Graft Survival by Recipient Sex |
| title_sort | differences in liver graft survival by recipient sex |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001084 |
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