ArticleHepatobiliary surgery and nutrition2025
Impact of donor-recipient sex-matching patterns on liver transplantation outcomes: a cohort study based on United Network of Organ Sharing data.
Article in Hepatobiliary surgery and nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Sexual dimorphism in the liver.Nature reviews. Gastroenterology & hepatology · 2026Review
- Reevaluating Donor-recipient Sex Mismatch and Survival After Liver Transplantation: A Contemporary Cohort Study.Transplantation direct · 2026Article
- Impact of Donor Age on Graft Failure After Deceased Donor Liver Transplantation by Donor-Recipient Sex Combinations: An Analysis of the UNOS OPTN Database.Journal of personalized medicine · 2025Article
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14 authors.
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Abstract
Background: The impact of donor-recipient sex-matching patterns on the outcomes of liver transplantation (LT) remains controversial. We aim to compare the long-term graft and recipient survival of LT among four donor-recipient sex-matching patterns using United Network of Organ Sharing (UNOS) database, and develop a grading system for prognostic stratification. Methods: Adult primary LT recipients from February, 2002 to June, 2022 in the UNOS database were divided into four donor-recipient sex groups, including female donor-female recipient (F-F) group, female donor-male recipient (F-M) group, male donor-female recipient (M-F) group and male donor-male recipient (M-M) group. Propensity score matching (PSM) analysis, inverse probability treatment weighting and multivariable adjustment were used to minimize between-group imbalances. Univariate and multivariate Cox regression analyses were performed to determine risk factors. Results: A total of 107,183 recipients were included, consisting of 46,037 (43.0%) recipients in M-M group, 25,699 (24.0%) in F-M group, 18,340 (17.1%) in M-F group and 17,107 (15.9%) in F-F group. After PSM, there were significant differences in the graft survival (GS) and overall survival (OS) among four groups (both P<0.001). F-F group showed best prognosis, with 1-, 5- and 10-year GS of 89.1%, 76.3% and 63.1%, respectively, while F-M group showed poor prognosis, with 1-, 5- and 10-year GS of 87.4%, 73.6% and 58.4%, respectively. In F-M group, three subgroups with distinctive prognosis were precisely stratified based on a grading system incorporating six independent risk factors. Conclusions: Donor-recipient sex-matching patterns significantly influence long-term LT outcomes. The grading system provides potential value to amend allocation process and optimize organ utility.
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