4-F PCC is associated with reduced blood product utilization 24 hours preoperatively and intraoperatively. Historically, the majority of patients require FFP for warfarin reversal preoperatively. In this single-center study, a significant reduction in the need for FFP was demonstrated with the use of 4-F PCC.

late outcomes were assessed by the type of donor-recipient gender match (primary analysis: female donor-male recipient [FD-MR, n= 36] vs. male donor-male recipient [MD-MR, n= 109]). Results: The FD-MR group experienced significantly higher rates of early major rejections per patient as compared with the MD-MR group (1.2±1.6 vs. 0.4±0.8; p= 0.001), higher rates of overall major rejections (16 vs. 5.5 per 100 person years; p< 0.05) and a higher rate of cardiac allograft vasculopathy (43% vs. 20%; p= 0.01). Multivariate analysis showed that FD-MR status was associated with > 2.5-fold (p= 0.03) increase in the risk for rejections and with a > 3-fold (p= 0.01) increase in the risk for major adverse events during follow-up. Kaplan-Meier survival analysis showed that the cumulative probabilities of survival free of rejections and major adverse events were significantly higher in MD-MR group (p= 0.002 and 0.001 respectively [Figure]). Risk of death by donorrecipient gender match did not differ between groups. Early mortality, need for inotropic support, length of hospital stay and major perioperative adverse events did not differ between the FD-MR and MD-MR groups. Conclusion: Donor-recipient gender mismatch is a powerful independent predictor of early and late rejections and long-term major adverse events following heart transplantation.