Donor gender effect on graft function in adult Egyptian patients undergoing living donor liver transplantation: A single centre study

Abstract

Background: The aim of this study was to evaluate the role of donor-to-recipient gender match in the setting of living donor liver transplant as a potential predictor of graft and recipient survivals. Methods: In this retrospective, single-center study, the data of 342 adult primary liver transplants were analyzed. The donor and recipient’s characters, intraoperative data, and postoperative outcomes were recorded. Results: The donor-recipient gender matched patients had significantly better graft survival outcomes than the gender mismatched ones. The 2-year graft survival probability was 95.7% in the matched group compared to 89.1% in the mismatched one (p = 0.026). A female donor-male recipient combination (87.3%) showed worse 2-years graft survival than a male-to-male transplant (94.8%), while it gave better graft survival than male to female (61.3%). The estimated relative risk of graft rejection was 5.91 times significantly higher in a male–female combination than in a male-to-male one (Hazard ratio = 5.91, 95% CI = 1.34–26.11). Conclusion: This study suggests that donor-recipient gender mismatch is associated with poor liver graft survival outcomes, with higher risk of graft rejection in male-female transplants than in male-to-male ones. Though, further larger studies including multiple datasets are needed, with adjustments for various graft, donor, and recipient factors to reach solid evidence.