Influence of Donor and Recipient Gender on the Outcome of Liver Transplantation12

Brooks, Barbara K.; Levy, Marlon F.; Jennings, Linda W.; Abbasoğlu, Osman; Vodapally, Mohan S.; Goldstein, Robert M.; Husberg, Bo S.; Gonwa, Thomas A.; Klintmalm, Göran B.

doi:10.1097/00007890-199612270-00017

Cited by 89 publications

(18 citation statements)

References 15 publications

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“…Although an association between female donors and negative postoperative outcome has been shown in some studies [55]–[58], we did not identify this correlation in our patient collective. Brooks, et al .…”

Section: Discussioncontrasting

confidence: 62%

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Prediction of Postoperative Mortality in Liver Transplantation in the Era of MELD-Based Liver Allocation: A Multivariate Analysis

et al. 2014

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Background and AimsLiver transplantation is the only curative treatment for end-stage liver disease. While waiting list mortality can be predicted by the MELD-score, reliable scoring systems for the postoperative period do not exist. This study's objective was to identify risk factors that contribute to postoperative mortality.MethodsBetween December 2006 and March 2011, 429 patients underwent liver transplantation in our department. Risk factors for postoperative mortality in 266 consecutive liver transplantations were identified using univariate and multivariate analyses. Patients who were <18 years, HU-listings, and split-, living related, combined or re-transplantations were excluded from the analysis. The correlation between number of risk factors and mortality was analyzed.ResultsA labMELD ≥20, female sex, coronary heart disease, donor risk index >1.5 and donor Na+>145 mmol/L were identified to be independent predictive factors for postoperative mortality. With increasing number of these risk-factors, postoperative 90-day and 1-year mortality increased (0–1: 0 and 0%; 2: 2.9 and 17.4%; 3: 5.6 and 16.8%; 4: 22.2 and 33.3%; 5–6: 60.9 and 66.2%).ConclusionsIn this analysis, a simple score was derived that adequately identified patients at risk after liver transplantation. Opening a discussion on the inclusion of these parameters in the process of organ allocation may be a worthwhile venture.

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Section: Discussioncontrasting

confidence: 62%

“…Brooks, et al . reported a decreased chance of survival when female livers were transplanted into male recipients [55]. Animal studies have revealed that estrogens have a biological influence on the long term postoperative outcome [59].…”

Section: Discussionmentioning

confidence: 99%

Prediction of Postoperative Mortality in Liver Transplantation in the Era of MELD-Based Liver Allocation: A Multivariate Analysis

et al. 2014

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“…In addition to CIT and preservation solution, many other donor and recipient factors have been hypothesized as contributing to poor outcomes [4], [5], [8], [9], [38], [50], [51], [52], [53], [54], [55]. Being able to use a simple blood test or patient historical factor to predict outcome prior to transplant has obvious advantages for making organ allocation decisions.…”

Section: Discussionmentioning

confidence: 99%

“…Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients, has recently has begun to publish the effect of cold-ischemia time (the time from clamping of the donor aorta until the anastomosis of the organ to the recipients vascular system or the organs disposal) on clinical outcomes- patient and graft survival [1]. Many other factors also contribute to the success or failure of an organ to function [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12] once transplanted and on patient and graft survival. However, cold-ischemia time also determines in part how far we can transport organs [13].…”

Section: Introductionmentioning

confidence: 99%

Consequences of Cold-Ischemia Time on Primary Nonfunction and Patient and Graft Survival in Liver Transplantation: A Meta-Analysis

et al. 2008

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IntroductionThe ability to preserve organs prior to transplant is essential to the organ allocation process.ObjectiveThe purpose of this study is to describe the functional relationship between cold-ischemia time (CIT) and primary nonfunction (PNF), patient and graft survival in liver transplant.MethodsTo identify relevant articles Medline, EMBASE and the Cochrane database, including the non-English literature identified in these databases, was searched from 1966 to April 2008. Two independent reviewers screened and extracted the data. CIT was analyzed both as a continuous variable and stratified by clinically relevant intervals. Nondichotomous variables were weighted by sample size. Percent variables were weighted by the inverse of the binomial variance.ResultsTwenty-six studies met criteria. Functionally, PNF% = −6.678281+0.9134701*CIT Mean+0.1250879*(CIT Mean−9.89535)2−0.0067663*(CIT Mean−9.89535)3, r2 = .625, , p<.0001. Mean patient survival: 93 % (1 month), 88 % (3 months), 83 % (6 months) and 83 % (12 months). Mean graft survival: 85.9 % (1 month), 80.5 % (3 months), 78.1 % (6 months) and 76.8 % (12 months). Maximum patient and graft survival occurred with CITs between 7.5–12.5 hrs at each survival interval. PNF was also significantly correlated with ICU time, % first time grafts and % immunologic mismatches.ConclusionThe results of this work imply that CIT may be the most important pre-transplant information needed in the decision to accept an organ.

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“…The donor's gender does not affect survival or outcome after liver transplantation [4,47]. Some older studies proposed that female livers have a lower survival and that a gender mismatch leads to higher graft failure; however, more recent studies could not support the assumed outcome differences related to donor gender [4,15,33,35,47,48,49,50,51,52]. During follow-up, no gender-related differences are being observed in the incidence of malignancies or rejections; however, more women develop renal dysfunction after liver transplantation [15,23,50,51,52,53,54,55].…”

Section: Liver Transplantationmentioning

confidence: 99%

Gender Mainstreaming and Transplant Surgery

et al. 2016

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Background: Gender differences in medicine are gaining in importance. In transplant surgery, not only the patient's gender but also that of the donor play an important role in the outcome of transplantation due to sociocultural and genetic factors. Methods: This review article gives an overview of the latest investigations into gender-related influences in the field of visceral transplantation. For this purpose, a systematic review of the literature was performed. Results: In general, women are less often evaluated for and subjected to transplantation worldwide. Significantly poorer outcome can be observed in women with liver transplantation following hepatitis C cirrhosis. Furthermore, female renal grafts are less favorable in terms of outcome and survival. Gender disparities affect transplant medicine due to subtle gender-specific immunological factors. Sociocultural factors also lead to differences in the clinical treatment of men and women, which may influence overall survival. Conclusion: For a better understanding of gender-specific differences in transplant medicine and a possible improvement in outcome, further research in this field is necessary.

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Influence of Donor and Recipient Gender on the Outcome of Liver Transplantation12

Abstract: The decreased graft survival rate in male recipients of female livers warrants further study and may argue for modifying the current management of adult male liver transplant recipients.

Cited by 89 publications

References 15 publications

Prediction of Postoperative Mortality in Liver Transplantation in the Era of MELD-Based Liver Allocation: A Multivariate Analysis

Prediction of Postoperative Mortality in Liver Transplantation in the Era of MELD-Based Liver Allocation: A Multivariate Analysis

Consequences of Cold-Ischemia Time on Primary Nonfunction and Patient and Graft Survival in Liver Transplantation: A Meta-Analysis

Gender Mainstreaming and Transplant Surgery

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