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. 2016 Jul 12:6:29298.
doi: 10.1038/srep29298.

Influence of donor-recipient sex mismatch on long-term survival of pancreatic grafts

Zhiwei Li  1 , Shengmin Mei  1 , Jie Xiang  1 , Jie Zhou  1 , Qijun Zhang  1 , Sheng Yan  1   2 , Lin Zhou  1   2 , Zhenhua Hu  1   2 , Shusen Zheng  1   2
Affiliations

Influence of donor-recipient sex mismatch on long-term survival of pancreatic grafts

Zhiwei Li et al. Sci Rep. .

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.

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Figures

Figure 1
Figure 1. Patient selection. PT, pancreas transplantation.
Figure 2
Figure 2. Kaplan–Meier pancreatic-graft survival curves for recipients with and without sex-mismatched donors.
Figure 3
Figure 3. Kaplan–Meier pancreatic-graft survival curves by donor–recipient sex pairing.
Figure 4
Figure 4
Estimated survival of pancreatic grafts stratified by donor–recipient sex pairing in transplant recipients aged 18–30 (A,D), 31–50 (B,E), and ≥51 years (C,F).
See this image and copyright information in PMC

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