P147. The Effect of Donor-Recipient Sex Matches on Lung Transplant Survival Rates: An Analysis of the UNOS Database.
Presented During: Thoracic Poster Session IV*
Temple University, Lewis Katz School of Medicine, Division of Cardiovascular Surgery
Gibsonia, PA
United States - Contact Me
MD Candidate Class of 2025 at the Lewis Katz School of Medicine at Temple University.
Monday, May 8, 2023: 3:35 PM - 3:39 PM
3 Minutes
Los Angeles Convention Center
Room: Exhibit Hall
Description
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.
Presentation Duration
2 minute presentation; 1 minute discussion.