title: Gender-based analysis of outcome after heart transplantation.
abstract: OBJECTIVE
  Gender differences between donors and recipients might have an effect on outcome after heart transplantation. Literature and registries reveal controversial results. We reviewed 1000 heart transplantations at our center focusing on the influence of gender differences on short- and long-term outcome after heart transplantation.
  
  
  METHODS
  We performed a retrospective analysis of 1000 (960 primary and 40 redo-heart transplantations) between August 1981 and July 2008. In contrast to other studies, the data for gender differences (donor gender and recipient gender) were evaluated for recipient survival and survival conditional to early mortality.
  
  
  RESULTS
  Female donors are significantly older than male donors (females, 36.5 ± 14.5 years; males, 31.2 ± 13.8 years). One-year survival was significantly inferior in male recipients receiving female donor hearts (mR/fD: 73.7%) compared to females receiving male donor organs (fR/mD: 90.9%) (P = .045). Univariate analysis revealed that, for recipients who survived > 1 year, survival at 10 years was significantly greater for female donors and female recipients (90%) than it was for male donors and male recipients (72%; P = .034). Multivariate analysis showed that the gender combination with female donors and female recipients was an independent indicator for greater long-term survival (P = .04).
  
  
  CONCLUSIONS
  The gender combination of female donors and male recipients had a greater risk for early mortality after heart transplantation, and the combination of male donors and female recipients resulted in favorable short-term outcomes. In long-term follow-up, recipients of hearts from female donors had better survival, especially female recipients.
authors: Department for Cardiac Surgery, Ludwig-Maximilians-University, Munich, Germany.
authors: Sandra
authors: S
authors: Eifert
authors: Sieglinde
authors: S
authors: Kofler
authors: Thomas
authors: T
authors: Nickel
authors: Sophia
authors: S
authors: Horster
authors: Amir Khosrow
authors: AK
authors: Bigdeli
authors: Andres
authors: A
authors: Beiras-Fernandez
authors: Bruno
authors: B
authors: Meiser
authors: Ingo
authors: I
authors: Kaczmarek
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005858:Germany; D016027:Heart Transplantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult