The Effect of Donor-Recipient Sex Matches on Lung Transplant Survival Rates: An Analysis of the UNOS Database.
Presented During:
Monday, May 8, 2023: 3:35PM - 3:39PM
Los Angeles Convention Center
Posted Room Name:
Exhibit Hall
Abstract No:
P0147
Submission Type:
Abstract Submission
Authors:
Elizabeth Profozich (1), Abul Kashem (2), Shaira Jafar (3), Huaqing Zhao (1), Ke Cheng (1), Hiromu Kehara (4), Norihisa Shigemura (5), Yoshiya Toyoda (6)
Institutions:
(1) Temple University, Lewis Katz School of Medicine, Division of Cardiovascular Surgery, Philadelphia, PA, (2) LKSOM at Temple University, Philadelphia, PA, (3) Barnard College, New York City, NY, (4) Temple University, Philadelphia, PA, (5) N/A, Philadelphia, PA, (6) Temple University Hospital, Philadelphia, PA
Submitting Author:
Elizabeth Profozich
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Temple University, Lewis Katz School of Medicine, Division of Cardiovascular Surgery
Temple University, Lewis Katz School of Medicine, Division of Cardiovascular Surgery
Co-Author(s):
Abul Kashem
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LKSOM at Temple University
LKSOM at Temple University
Shaira Jafar
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Barnard College
Barnard College
Huaqing Zhao
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Temple University, Lewis Katz School of Medicine, Division of Cardiovascular Surgery
Temple University, Lewis Katz School of Medicine, Division of Cardiovascular Surgery
Ke Cheng
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Temple University, Lewis Katz School of Medicine, Division of Cardiovascular Surgery
Temple University, Lewis Katz School of Medicine, Division of Cardiovascular Surgery
Hiromu Kehara
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Temple University
Temple University
Norihisa Shigemura
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N/A
N/A
*Yoshiya Toyoda
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Temple University Hospital
Temple University Hospital
Presenting Author:
Elizabeth Profozich
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Temple University, Lewis Katz School of Medicine, Division of Cardiovascular Surgery
Temple University, Lewis Katz School of Medicine, Division of Cardiovascular Surgery
Abstract:
Objective: Due to relatively lower life expectancy post-lung transplantation, research has focused on optimizing donor-recipient (DR) matches to increase survival time. The significance of DR sex matches on survival outcomes still remains inconclusive. The purpose of this study is to investigate this relationship in United Network of Organ Sharing (UNOS) database of lung transplantation recipients.
Methods: We performed a retrospective study of 29,310 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). Survival for each group was assessed using a Kaplan-Meier curve and log-rank tests for 1-, 3-, 5-, and 10- year survival. Cox proportional hazards regression and analysis of maximum likelihood estimates for 15-year survival were also performed using the following variables: recipient age, recipient BMI, recipient height, lung allocation score, transplant type, donor age, and DR sex match. P-values <0.05 were considered significant.
Results: Of the 29,310 patients who received lung transplants, 12772 were MM, 4861 were MF, 7165 were FF, and 4512 were FM. There was a significant difference in 1-, 3-, 5-, and 10- year survival outcomes when comparing the donor-recipient sex matched groups (P < 0.0001). The analysis of maximum likelihood estimates showed older recipient age (Hz = 1.006, 95%CI = 1.004-1.007; p<0.0001), higher lung allocation score (Hz = 1.006, 95%CI = 1.005-1.007; p<0.0001), older donor age (Hz = 1.003, 95%CI = 1.002-1.005; p<0.0001), and FM lung transplants were correlated with poorer survival outcomes. In contrast, taller recipient height (Hz = 0.997, 95%CI= 0.995-0.999; p=0.0053) and double lung transplants (Hz = 0.751, 95%CI= 0.721-0.783; p<0.0001) were associated with better survival outcomes. Recipient BMI (Hz = 1.002, 95%CI= 0.997-1.006; p<0.4093) had no effect on survival outcomes.
Conclusions: Post-lung transplant 1-, 3-, 5-, and 10-year survival outcomes were significantly different between DR sex matched groups. Importantly, female to male lung transplants were associated with the poorest survival outcomes for each survival analysis.
Methods: We performed a retrospective study of 29,310 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). Survival for each group was assessed using a Kaplan-Meier curve and log-rank tests for 1-, 3-, 5-, and 10- year survival. Cox proportional hazards regression and analysis of maximum likelihood estimates for 15-year survival were also performed using the following variables: recipient age, recipient BMI, recipient height, lung allocation score, transplant type, donor age, and DR sex match. P-values <0.05 were considered significant.
Results: Of the 29,310 patients who received lung transplants, 12772 were MM, 4861 were MF, 7165 were FF, and 4512 were FM. There was a significant difference in 1-, 3-, 5-, and 10- year survival outcomes when comparing the donor-recipient sex matched groups (P < 0.0001). The analysis of maximum likelihood estimates showed older recipient age (Hz = 1.006, 95%CI = 1.004-1.007; p<0.0001), higher lung allocation score (Hz = 1.006, 95%CI = 1.005-1.007; p<0.0001), older donor age (Hz = 1.003, 95%CI = 1.002-1.005; p<0.0001), and FM lung transplants were correlated with poorer survival outcomes. In contrast, taller recipient height (Hz = 0.997, 95%CI= 0.995-0.999; p=0.0053) and double lung transplants (Hz = 0.751, 95%CI= 0.721-0.783; p<0.0001) were associated with better survival outcomes. Recipient BMI (Hz = 1.002, 95%CI= 0.997-1.006; p<0.4093) had no effect on survival outcomes.
Conclusions: Post-lung transplant 1-, 3-, 5-, and 10-year survival outcomes were significantly different between DR sex matched groups. Importantly, female to male lung transplants were associated with the poorest survival outcomes for each survival analysis.
THORACIC:
End Stage Lung Disease and Lung Transplantation
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