Martinez-Selles Manuel, Almenar Luis, Paniagua-Martin Maria J, Segovia Javier, Delgado Juan F, Arizón Jose M, Ayesta Ana, Lage Ernesto, Brossa Vicens, Manito Nicolás, Pérez-Villa Félix, Diaz-Molina Beatriz, Rábago Gregorio, Blasco-Peiró Teresa, De La Fuente Galán Luis, Pascual-Figal Domingo, Gonzalez-Vilchez Francisco
Hospital Universitario Gregorio Marañón, Universidad Europea de Madrid, Madrid, Spain.
Transpl Int. 2015 Mar;28(3):305-13. doi: 10.1111/tri.12488. Epub 2014 Nov 27.
The results of studies on the association between sex mismatch and survival after heart transplantation are conflicting. Data from the Spanish Heart Transplantation Registry. From 4625 recipients, 3707 (80%) were men. The donor was female in 943 male recipients (25%) and male in 481 female recipients (52%). Recipients of male hearts had a higher body mass index (25.9 ± 4.1 vs. 24.3 ± 3.7; P < 0.01), and male donors were younger than female donors (33.4 ± 12.7 vs. 38.2 ± 12.3; P < 0.01). No further relevant differences related to donor sex were detected. In the univariate analysis, mismatch was associated with mortality in men (hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.06-1.32; P = 0.003) but not in women (HR, 0.91; 95% CI 0.74-1.12; P = 0.4). A significant interaction was detected between sex mismatch and recipient gender (P = 0.02). In the multivariate analysis, sex mismatch was associated with long-term mortality (HR, 1.14; 95% CI 1.01-1.29; P = 0.04), and there was a tendency toward significance for the interaction between sex mismatch and recipient gender (P = 0.08). In male recipients, mismatch increased mortality mainly during the first month and in patients with pulmonary gradient >13 mmHg. Sex mismatch seems to be associated with mortality after heart transplantation in men but not in women.
关于性别不匹配与心脏移植后生存率之间关联的研究结果相互矛盾。来自西班牙心脏移植登记处的数据。在4625名接受者中，3707名（80%）为男性。943名男性接受者（25%）的供体为女性，481名女性接受者（52%）的供体为男性。接受男性心脏的接受者体重指数较高（25.9±4.1 vs. 24.3±3.7；P<0.01），男性供体比女性供体年轻（33.4±12.7 vs. 38.2±12.3；P<0.01）。未检测到与供体性别相关的其他显著差异。在单因素分析中，性别不匹配与男性死亡率相关（风险比[HR]，1.18；95%置信区间[CI]，1.06 - 1.32；P = 0.003），但与女性无关（HR，0.91；95%CI 0.74 - 1.12；P = 0.4）。检测到性别不匹配与接受者性别之间存在显著交互作用（P = 0.02）。在多因素分析中，性别不匹配与长期死亡率相关（HR，1.14；95%CI 1.01 - 1.29；P = 0.04），性别不匹配与接受者性别之间的交互作用有显著趋势（P = 0.08）。在男性接受者中，性别不匹配主要在第一个月以及肺压差>13 mmHg的患者中增加死亡率。性别不匹配似乎与男性心脏移植后的死亡率相关，但与女性无关。
