Relevance of male-to-female sex mismatch in liver transplantation for primary biliary cirrhosis.
BACKGROUND
Because male-to-female transplantations are related to exposure to H-Y antigen, sex matching may influence the outcomes after liver transplantation for autoimmune diseases. The purpose of this retrospective study was to evaluate the relevance of male-to-female mismatch in liver transplantation for primary biliary cirrhosis (PBC).


METHODS
This retrospective study was based on the data of 82 female liver transplant recipients with PBC from a single institution. The primary outcome measure was graft survival at 10 years. The negative effects of well-known risk factors for poor outcomes were evaluated separately and compared between the female-to-female and male-to-female transplantations.


RESULTS
Graft survival was similar after female-to-female and male-to-female transplantations (74.7% versus 73.1% at 10 years, respectively, p=0.676). Regarding the differential impact of other risk factors, prolonged cold ischemia and increased amount of blood transfusions adversely influenced outcomes after male-to-female transplantation (p=0.039 and p=0.039, respectively) but not after female-to-female transplantation (p=0.843 and p=0.110, respectively). Sex mismatched transplantations were associated with lower 10-year graft survival in subgroups of patients with blood transfusions >4 units (61.4% versus 100.0%, p=0.063) and >8 hours of cold ischemia (54.7% versus 75.8%, p=0.418).


CONCLUSIONS
Although male-to-female sex mismatch does not seem to yield a direct negative impact on outcomes following liver transplantation for PBC, it can aggravate the negative effects of prolonged cold ischemia and blood transfusions.
Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
Michał
M
Grąt
Department of Epidemiology, Medical University of Warsaw, Warsaw, Poland.
Zbigniew
Z
Lewandowski
Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
Waldemar
W
Patkowski
Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
Karolina Maria
KM
Wronka
Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
Karolina
K
Grąt
Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
Maciej
M
Krasnodębski
Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
Joanna
J
Ligocka
Department of Laboratory Diagnostics, Medical University of Warsaw, Warsaw, Poland.
Hanna
H
Zborowska
Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
Marek
M
Krawczyk
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D046148:Donor Selection; D005260:Female; D006084:Graft Rejection / Q000209:etiology*; D006085:Graft Survival; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult