GENDER MATCHING AND OUTCOME AFTER PEDIATRIC LIVER-TRANSPLANTATION

Background. Gender is not a selection criterion for orthotopic liver t ransplantation (OLT), and reports in adults have shown a less favorabl e outcome for male recipients of female organs; the only pediatric stu dy did not support this finding. The aim of the present study was to a ssess the impact of donor and recipient gender on graft and patient su rvival rates after pediatric OLT, Methods. We have reviewed retrospect ively 137 children (male=63; median age: 3.4 years; range: 14 days to 15 years) undergoing primary OLT from January 1991 to June 1996, These children were divided into donor-recipient gender match (M; n=64) and nonmatch (NM; n=73) groups and then classified into female to female (FF; n=30), female to male (FM; n=29), male to female (IMF; n=44), and male to male (MM; n=34) subgroups. Results. The M group had better gr aft and patient survival rates at both 1- and B-year follow-up compare d with the NM group (P<0.01). Graft and patient survival rates were di fferent among gender subgroups (P<0.04). Graft and patient survival ra tes in the FM group were poorer than in the MM subgroup at both 1 and 5 years (P<0.03, P<0.01). The FM group had a higher incidence of early complications than the MM (P<0.01) group, with 50% and 33% of graft l osses, respectively, related to the complications. To minimize the inf luence of hormonal factors, we have analyzed separately the patients y ounger than 12 and 10 years who had similar findings. Conclusion. Graf t and patient survival rates after pediatric OLT are worse in gender m ismatch groups, particularly for male recipients of female organs. Ear ly complications play a role in the decreased survival rates.