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Review
. 2015 Apr;62(4):946-55.
doi: 10.1016/j.jhep.2014.11.023. Epub 2014 Nov 27.

Outcomes in liver transplantation: does sex matter?

Monika Sarkar  1 , Kymberly D Watt  2 , Norah Terrault  3 , Marina Berenguer  4
Affiliations
Review

Outcomes in liver transplantation: does sex matter?

Monika Sarkar et al. J Hepatol. 2015 Apr.

Abstract

A growing literature has highlighted important differences in transplant-related outcomes between men and women. In the United States there are fewer women than men on the liver transplant waitlist and women are two times less likely to receive a deceased or living-related liver transplant. Sex-based differences exist not only in waitlist but also in post-transplant outcomes, particularly in some specific liver diseases, such as hepatitis C. In the era of individualized medicine, recognition of these differences in the approach to pre and post-liver transplant care may impact short and long-term outcomes.

Keywords: Hepatitis C virus; Liver allocation; Liver transplantation; MELD score; Quality of life; Sex; Waitlist outcome; Women’s health.

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Conflict of interest statement

Conflict of interest

The authors declared that they do not have anything to disclose regarding funding or conflict of interest with respect to this manuscript.

Figures

Fig. 1
Fig. 1. Post-MELD era waitlist and transplant numbers by sex
(A) Post-MELD era waitlist by sex. Number of women and men in the U.S. listed for liver transplant based on data from the Scientific Registry of Transplant Recipients (SRTR) in the post-MELD era. (B) Post-MELD era transplant numbers by sex. Number of women and men receiving live and deceased donor liver transplants in the U.S. based on SRTR data in the post-MELD era.
Fig. 2
Fig. 2. Post-MELD era waitlist mortality by sex
Number of deaths among women and men in the U.S. based on SRTR data in the post-MELD era. Those delisted as too sick for transplant are not included.
Fig. 3
Fig. 3. Indications for liver transplantation in 2013 in the US by sex
(A) Indications for liver transplants in 2013 among U.S. women based on UNOS data. (B) Indications for liver transplants in 2013 among U.S. men based on UNOS data. ALD, alcohol liver disease; PBC, primary biliary cirrhosis; HCV, hepatitis C virus; HCC, hepatocellular carcinoma; PSC, primary sclerosing cholangitis; AIH, autoimmune hepatitis; HBV, hepatitis B virus; NAFLD, non-alcoholic fatty liver disease.
Fig. 4
Fig. 4. Indications for liver transplantation in 2012 in Europe by sex
(A) Indications for liver transplants in 2012 among European women based on ELTR data. (B) Indications for liver transplants in 2012 among European men based on ELTR data (data kindly provided by V. Karam).
See this image and copyright information in PMC

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