The effect of donor–recipient sex matches on lung transplant survival: An analysis of the United Network for Organ Sharing databaseCentral MessagePerspective
Elizabeth Profozich, BS,
Abul Kashem, MD, PhD,
Roh Yanagida, MD, PhD,
Manish Suryapalam, BS,
Ke Cheng, PhD,
Hiromu Kehara, MD, PhD,
Norihisa Shigemura, MD, PhD,
Yoshiya Toyoda, MD, PhD
Affiliations
Elizabeth Profozich, BS
Division of Cardiovascular Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa
Abul Kashem, MD, PhD
Address for reprints: Abul Kashem, MD, PhD, Cardiovascular Surgery, Lewis Katz School of Medicine at Temple University, 3401 North Broad St, Suite 301, 3rd Floor Zone C, Philadelphia, PA 19140.; Division of Cardiovascular Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa
Roh Yanagida, MD, PhD
Division of Cardiovascular Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa
Manish Suryapalam, BS
Division of Cardiovascular Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa
Ke Cheng, PhD
Division of Cardiovascular Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa
Hiromu Kehara, MD, PhD
Division of Cardiovascular Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa
Norihisa Shigemura, MD, PhD
Division of Cardiovascular Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa
Yoshiya Toyoda, MD, PhD
Division of Cardiovascular Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa
Objective: To investigate the impact of donor–recipient (DR) sex matches on survival after lung transplantation while controlling for size difference in the United Network of Organ Sharing (UNOS) database. Methods: We performed a retrospective study of 27,423 lung transplant recipients who were reported in the UNOS database (January 2005-March 2020). Patients were divided into groups based on their respective DR sex match: male to male (MM), male to female (MF), female to female, (FF), and female to male (FM). Kaplan–Meier curve and Cox regression with log-rank tests were used to assess 1-, 3-, 5-, and 10-year survival. We also modeled survival for each group after controlling for size-related variables via the Cox regression. Results: Kaplan–Meier curves showed overall significance at 1-, 3-, 5-, and 10-year end points (P < .0001). Estimated median survival time based on Kaplan–Meier analysis were 6.41 ± 0.15, 6.13 ± 0.18, 5.86 ± 0.10, and 5.37 ± 0.17 years for FF, MF, MM, and FM, respectively (P < .0001). After we controlled for size differences, FF had statistically significantly longer 5- and 10-year survival than all other cohorts. MF also had statistically significantly longer 5- and 10-year survival than FM. Conclusions: When variables associated with size were controlled for, FF had improved survival than other DR groups. A female recipient may experience longer survival with a female donor’s lungs versus a male donor’s lungs of similar size.
