Recipient-Donor Sex Constellation in Liver Transplantation for Hepatocellular Carcinoma-An ELTR Study

Fecha de publicación: 01/01/2025 Fecha Ahead of Print: 01/11/2024

Autores de IIS La Fe

Andrea Boscà Robledo

Autor

Participantes ajenos a IIS La Fe

Magyar, Christian Tibor Josef
Arteaga, Noah Free
Germani, Giacomo
Karam, Vincent Hassan
Adam, Rene
Romagnoli, Renato
De Simone, Paolo
Robin, Fabien
Cherqui, Daniel
Mazzaferro, Vincenzo
Fundora, Yiliam
Heneghan, Michael
Llado, Laura
Lesurtel, Mickael
Cescon, Matteo
Mirza, Darius
Cavelti, Andrea
Christen, Lucienne
Storni, Federico
Kim-Fuchs, Corina
Lachenmayer, Anja
Beldi, Guido
Candinas, Daniel
Radu, Iuliana-Pompilia
Schwacha-Eipper, Birgit
Berzigotti, Annalisa
Banz, Vanessa
European Liver & Intestine Transplant Assoc ELITA

Grupos

Hepatología, Cirugia Hepatobiliopancreática y Trasplantes

Leader

Marina Berenguer Haym

Abstract

Background & AimsHepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide. Liver transplantation (LT) is a curative treatment option. We investigated survival outcomes based on recipient-donor sex constellation (RDSC) following LT.MethodsWe performed a European Liver Transplant Registry analysis, including patients from 1988 to December 2022. The cohort was split into four RDSC groups: female donor female recipient (FDFR), female donor male recipient (FDMR), male donor female recipient (MDFR) and male donor male recipient (MDMR). Survival analysis, including death with recurrence, was performed.ResultsIn 7601 LT for HCC with an overall median follow-up of 22.6 months (5.8, 60.7), death was registered in 25.1% and, as primary cause of death, HCC tumour recurrence in 26.0%. There was no statistically significant difference on crude survival estimates among the different RDSC groups (log-rank p = 0.66) with 10-year overall survival (OS) of 54.5% in FDFR, 54.6% in FDMR, 59.1% in MDFR and 56.9% in MDMR. On multivariable analysis, RDSC showed a significant effect on OS (FDFR as reference): MDFR (aHR 0.72, p = 0.023). No significant difference was found for FDMR (aHR 0.98, p = 0.821) and MDMR (aHR 0.90, p= 0.288). Regarding overall registered causes of death, differences between RDSC groups were found in rejection (p = 0.017) and cardiovascular (p = 0.046) associated deaths.ConclusionsIn female recipients undergoing LT for HCC, male donor grafts were associated with a 28% reduction of mortality compared to female donor grafts.