Purpose
To clarify the significance of recipient gender status on lung transplant outcomes in a large single institution experience spanning three decades.
Methods
We analyzed data from all lung transplants performed in our institution since 1986. Kaplan-Meier curves and Cox proportional hazard models were used to evaluate the effect of recipient characteristics on survival and BOS score ≥1-free survival. Logistic regression analysis was used to explore the association of gender with short term graft function.
Results
876 lung transplants were performed between 1986 and 2016. Kaplan-Meier survival estimates at 5 years post-transplant for females versus males in the LAS era were 71% versus 58%. In the LAS era females showed greater unadjusted BOS ≥ 1-free survival than males (35% vs 25%, P=0.02] over 5 years. Female gender was the only factor in the LAS era significantly associated with improved adjusted 5 year survival [HR 0.56 (95% CI 0.33, 0.95) P=0.03]. Conversely, in the pre-LAS era female gender was not associated with improved survival.
Conclusion
Female recipients showed significantly improved survival over 5 years compared to males in the LAS era. A prospective analysis of biologic and immunologic differences is warranted.