The impact of donor gender on cardiac peri-transplantation ischemia injury.
BACKGROUND
Cardiac allografts from female donors have been shown to be associated with increased risk of transplant vasculopathy. However, the influence of donor gender on peri-transplantation ischemic injury has not been evaluated.


METHODS
A total of 361 patients (mean age, 52 +/- 10 years) underwent cardiac transplantation between January 1998 and December 2002. Patients were divided into 4 groups according to their donor-recipient gender status: Group A, male-male, 156; Group B, male-female, 37; Group C, female-male, 114; and Group D, female-female, 54. Serial right ventricular endomyocardial biopsy specimens were evaluated for ischemic injury during the first 4 weeks after transplantation.


RESULTS
Patients were similar in baseline characteristics. An increased incidence of ischemic injury complicated by fibrosis (12.9%, p = 0.03) and subsequent development of transplant vasculopathy (Kaplan-Meier 6-year freedom from vasculopathy, 53.4%; p = 0.012) was noted in Group D. No survival difference was observed among the 4 groups, however. In Group D (F-F), 2 patients underwent retransplantation and 2 patients underwent revascularization.


CONCLUSIONS
The transplantation of a female cardiac allograft into a female recipient is associated with increased risk of ischemic injury complicated by fibrosis and subsequent transplant vasculopathy.
Yamani
Mohamad H
MH
Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Kaufman Center for Heart Failure, Cleveland, Ohio 44195, USA. yamanim@ccf.org
Erinc
Sabri K
SK
McNeill
Ann
A
Ratliff
Norman B
NB
Sendrey
Dianna
D
Zhou
Lingmei
L
Cook
Daniel J
DJ
Hobbs
Robert
R
Rincon
Gustavo
G
Bott-Silverman
Corinne
C
Young
James B
JB
Banbury
Michael
M
Navia
Jose
J
Smedira
Nicholas
N
Starling
Randall C
RC
D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000601:surgery; D017023:Coronary Angiography; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D005355:Fibrosis; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology* / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology; D012189:Retrospective Studies; D012737:Sex Factors; D014019:Tissue Donors; D014184:Transplantation, Homologous