Mortality, rehospitalization, and post-transplant complications in gender-mismatched heart transplant recipients.
Anne Jalowiec, Kathleen L Grady, Connie White-Williams
PMID 28501318WHAT IT FOUND
Female heart transplant recipients who received male donor hearts had worse 3-year outcomes: more deaths, shorter survival, more rehospitalizations, treated acute rejection, and CAV.
Rejection and infection were leading causes of death.
Key findings
0141.2% of female-mismatched recipients (male donor/female recipient) died within 3 years, compared with 17.9% of no-mismatched recipients and 22.5% of male-mismatched recipients.
02Female-mismatched recipients had more rehospitalizations, more treated acute rejection episodes, and a 32.4% CAV incidence, compared with 12.1% in no-mismatched and 12.5% in male-mismatched recipients.
03The female-mismatched group included 38.2% minority patients, but race was not controlled because only 51 minorities were in the whole sample.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 74 of 347 patients were gender-mismatched, and the female-mismatch group had 34 patients, so the estimates are imprecise. The female-mismatch group had only 14 deaths, so the 41.2% mortality rests on a small number. Race was not controlled because only 51 minorities were in the whole sample, while 38.2% of the female-mismatch group were minority patients. The groups differed at baseline in donor age, creatinine, CMV mismatch, ischemic heart disease, and minority status, so worse outcomes may not be due to gender mismatch alone. This was an observational study, so it cannot show that gender mismatch caused worse outcomes.
Declared interests
The paper states the clinical data came from a 10-year NIH-funded study. No other funding or author conflict-of-interest declaration is reported in the supplied text.
The easy way to misread this
Do not conclude that male donor hearts caused worse outcomes in female recipients. This was an observational study, the female-mismatch group had only 34 patients and 14 deaths, and race was not controlled even though 38.2% of that group were minority patients.