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Meta-Analysis
. 2019 Dec;33(12):e13737.
doi: 10.1111/ctr.13737. Epub 2019 Nov 10.

Sex-mismatch influence on survival after heart transplantation: A systematic review and meta-analysis of observational studies

Ana Ayesta  1 , Gerard Urrútia  2   3   4 , Eva Madrid  4   5   6 , Robin W M Vernooij  4 , Lourdes Vicent  7   8 , Manuel Martínez-Sellés  7   8   9
Affiliations
Meta-Analysis

Sex-mismatch influence on survival after heart transplantation: A systematic review and meta-analysis of observational studies

Ana Ayesta et al. Clin Transplant. 2019 Dec.

Abstract

Introduction and objectives: Heart transplantation (HT) is the treatment for patients with end-stage heart disease. Despite contradictory reports, survival seems to be worse when donor/recipient sex is mismatched. This systematic review and meta-analysis aims to synthesize the evidence on the effect of donor/recipient sex mismatch after HT.

Methods: We searched PubMed and EMBASE until November 2017. Comparative cohort and registry studies were included. Published articles were systematically selected and, when possible, pooled in a meta-analysis. The primary endpoint was one-year mortality.

Results: After retrieving 556 articles, ten studies (76 175 patients) were included in the quantitative meta-analysis. Significant differences were found in one-year survival between sex-matched and mismatched recipients (odds ratio (OR) 1.30, 95% confidence interval (CI) 1.25-1.35, P < .001). In female recipients, we found that sex mismatch was not a risk factor for one-year mortality (OR = 0.93, 95% CI = 0.85-1.00, P = .06). However, in male recipients, we found that it was a risk factor for one-year mortality (OR = 1.38, 95% CI = 1.31-1.44, P < .001).

Conclusions: Sex mismatch increases one-year mortality after HT in male recipients. Its influence in long-term survival should be further explored with high-quality studies.

Keywords: heart transplantation; meta-analysis; mismatch; prognosis; sex.

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References

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