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Editorials

Sex Matters, But to What Clinical Avail?

Jennifer C. Matthews, MD, MS and Keith D. Aaronson, MD, MS

From the Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Mich.

Correspondence to Keith Aaronson, MD, Division of Cardiovascular Medicine, University of Michigan Medical Center, 1500 East Medical Center Drive, CVC Room 2169, SPC 5183, Ann Arbor, MI 48109-5183. E-mail keith@umich.edu

Key Words: immunology • sex factors • survival • prognosis • transplantation • risk factors

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Despite substantial advances in mechanical circulatory support, cardiac transplantation remains the "gold standard" treatment option for eligible patients with American Heart Association/American College of Cardiology class D end-stage heart failure. Transplant survival rates have progressively improved at all time points, with 55% of recipients now surviving 10 years after transplantation, despite an increase in donor and recipient age and comorbidity and greater recipient urgency. Survival has improved with every 5- to 10-year era, but most of the mortality aversion is in the first 6 to 12 months.^1,2

Article see p 401

In this issue of Circulation: Heart Failure, Weiss and colleagues³ from The Johns Hopkins University, evaluated United Network for Organ Sharing data on all first US adult heart transplantations from 1998 to 2007 (n=18,240). The authors show that female recipients had marginally (P=0.06) worse 5-year survival than male recipients (absolute increase risk of 3.6%; 11% higher risk-adjusted mortality). However, the overall better survival in male recipients was present only in male recipients of a male donor; by using multivariable Cox modeling, they found that male recipients of a female donor (FD/MR) were 15% more likely to die than male recipients of a male donor (MD/MR). Moreover, after the addition of propensity adjustment for the likelihood of receiving a same-sex donor, the FD/MR group was 20% more likely to die than those male recipients who received a same-sex donor. The survivals of donor/recipient sex-matched female (FD/FR) and male (MD/MR) recipients were statistically indistinguishable after multivariable adjustment (with . . . [Full Text of this Article]

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The Impact of Donor-Recipient Sex Matching on Survival After Orthotopic Heart Transplantation: Analysis of 18 000 Transplants in the Modern Era

Eric S. Weiss, Jeremiah G. Allen, Nishant D. Patel, Stuart D. Russell, William A. Baumgartner, Ashish S. Shah, and John V. Conte
Circ Heart Fail 2009 2: 401-408. [Abstract] [Full Text] [PDF]