title: Gender does matter: gender-specific outcome analysis of 67,855 heart transplants.
abstract: BACKGROUND
  Gender differences between donor and recipient might have an impact on the outcome after heart transplantation (HT). Data of more than 67,000 patients registered at the International Society of Heart Lung Transplantation (ISHLT) were reviewed focusing on the influence of gender differences on short- and long-term outcome after HT.
  
  
  METHODS
  We performed a retrospective analysis of 67,855 cardiac allograft recipients. They received orthotopic HT between January 1, 1980 and June 30, 2009. In contrast to other studies the data for gender differences (donor gender and recipient gender) were calculated with respect to actuarial and conditional survival (without 30-day mortality).
  
  
  RESULTS
  One-year survival was highest in male recipients of male donor hearts (mR/mD: 83.74%). The lowest 1-year outcome showed male recipients of female donor organs (mR/fD: 78.95%). Best 5-year survival rates were shown by male recipients with male donor organs (70.75%, p < 0.0001). These differences disappeared in survival conditional to 1 year, indicating that gender predominantly influences short-term outcome.
  
  
  CONCLUSIONS
  The combination male recipient/female donor carries a higher risk for early mortality, whereas female recipients/male donor reveals favorable short-term results. Gender-matched HT would be ideal, but not suitable in practice because of the shortage of organs.
authors.affiliation: Department of Cardiac Surgery, Grosshadern University Hospital, LMU-University, Munich, Germany. ingo.kaczmarek@med.uni-muenchen.de
authors.forename: Ingo
authors.initials: I
authors.lastname: Kaczmarek
authors.forename: Bruno
authors.initials: B
authors.lastname: Meiser
authors.forename: Andres
authors.initials: A
authors.lastname: Beiras-Fernandez
authors.forename: Sonja
authors.initials: S
authors.lastname: Guethoff
authors.forename: Peter
authors.initials: P
authors.lastname: Überfuhr
authors.forename: Martin
authors.initials: M
authors.lastname: Angele
authors.forename: Ute
authors.initials: U
authors.lastname: Seeland
authors.forename: Christian
authors.initials: C
authors.lastname: Hagl
authors.forename: Bruno
authors.initials: B
authors.lastname: Reichart
authors.forename: Sandra
authors.initials: S
authors.lastname: Eifert
mesh_terms: D016009:Chi-Square Distribution; D005260:Female; D006085:Graft Survival; D016027:Heart Transplantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D012042:Registries; 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