Effect of gender mismatch on survival in lung transplant patients

Purpose: Gender mismatch has recently been associated with decreased survival in heart transplantation when a female donor heart was transplanted to a male recipient. (J Heart Lung Transplant 1996;15(1):33A). The effect of gender mismatch in lung transplantation is not clear. This study investigated the impact of gender mismatch on lung transplant survival at a single institution. Methods: We retrospectively reviewed the survival data of lung transplantation gender match and mismatch at our institution between 1987 and 1995. Patients were divided into four groups of donor-recipient (D-R) pairs: male to male (MM), male to female (MF), female to female (FF), and female to male (FM). Results: There were significantly fewer female donors compared to male donors (M:F ratio 4.7:1). No significant differences were found among the four groups in recipient diagnosis, total ischemic time and length of hospital stay. The following table shows the survival data: Percent Survival D-R 1 Year 2 Year 3 Year MM 62 (28/45) 53 (20/38) 38 (13/34) MF 56 (22/39) 46 (17/37) 42 (13/31) FF 92 (12/13) 67 (8/12) 44 (4/9) FM 60 (3/5) 40 (2/5) 33 (1/3) Total 64 51 40 Conclusions: Gender match from female donor to female recipient appears to have the highest survival rates. Gender mismatch from female donor to male recipient appears to have slightly lower two-year and three-year survival rates compared to gender matched pairs. However, given the few number of patients in this group, the clinical significance of this finding is unclear. Clinical Implications: Given the current shortage of organ donors, the small differences in survival rates in gender mismatch do not favor gender matching in lung transplantation.