Mortality and Causes of Death After Liver Transplantation: Analysis of Sex Differences in a Large Nationwide Cohort

Serrano, M. Trinidad (Universidad de Zaragoza) ; Sabroso, Sergio ; Esteban, Luis M. ; Berenguer, Marina ; Fondevila, Constantino ; Lorente, Sara (Universidad de Zaragoza) ; Cortés, Luis (Universidad de Zaragoza) ; Sanchez-Antolin, Gloria ; Nuño, Javier ; De la Rosa, Gloria ; Salcedo, Magdalena

Resumen: In the last few years, several studies have analyzed sex and gender differences in liver transplantation (LT), but none have performed a disaggregated analysis of both mortality and causes of death. Data from 15,998 patients, 11,914 (74.5%) males and 4,069 (25.5%) females, transplanted between 2000 and 2016 were obtained from the Liver Transplantation Spanish Registry. Survival analysis was applied to explore recipient sex as a risk factor for death. The causes of death at different follow-up duration were disaggregated by recipient sex for analysis. Short-term survival was higher in males, whereas long-term survival was higher in females. Survival at 1, 5 and 10 years post-transplant was 87.43%, 73.83%, and 61.23%, respectively, in males and 86.28%, 74.19%, and 65.10%, respectively, in females (p = 0.05). Post-LT mortality related to previous liver disease also presented sex differences. Males had 37% increased overall mortality from acute liver failure (p = 0.035) and 37% from HCV-negative cirrhosis (p < 0.001). Females had approximately 16% increased mortality when the liver disease was HCV-positive cirrhosis (p = 0.003). Regarding causes of death, non-malignancy HCV+ recurrence (6.3% vs. 3.9% of patients; p < 0.001), was more frequently reported in females. By contrast, death because of malignancy recurrence (3.9% vs. 2.2% of patients; p = 0.003) and de novo malignancy (4.8% vs. 2.5% of patients; p < 0.001) were significantly more frequent in male recipients. Cardiovascular disease, renal failure, and surgical complications were similar in both. In summary, male patients have lower short-term mortality than females but higher long-term and overall mortality. In addition, the post-LT mortality risk related to previous liver disease and the causes of mortality differ between males and females.

Idioma: Inglés

DOI: 10.3389/ti.2022.10263

Año: 2022

Publicado en: TRANSPLANT INTERNATIONAL 35 (2022), 10263 [12 pp.]
ISSN: 0934-0874

Factor impacto JCR: 3.1 (2022)

Categ. JCR: SURGERY rank: 50 / 213 = 0.235 (2022) - Q1 - T1
Categ. JCR: TRANSPLANTATION rank: 14 / 26 = 0.538 (2022) - Q3 - T2

Factor impacto CITESCORE: 4.5 - Medicine (Q2)

Factor impacto SCIMAGO: 0.807 - Transplantation (Q2)

Financiación: info:eu-repo/grantAgreement/ES/DGA-FSE/RIS3-LMP223-18

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)