RT Journal Article
SR Electronic
T1 Influence of sex on outcomes of liver transplantation for hepatocellular carcinoma: a multicenter cohort study in China
JF Cancer Biology & Medicine
JO Cancer Biology & Medicine
FD China Anti-Cancer Association
SP 20230453
DO 10.20892/j.issn.2095-3941.2023.0453
A1 Jian Chen
A1 Zhe Yang
A1 Fengqiang Gao
A1 Zhisheng Zhou
A1 Junli Chen
A1 Di Lu
A1 Kai Wang
A1 Meihua Sui
A1 Zhengxin Wang
A1 Wenzhi Guo
A1 Guoyue Lyu
A1 Haizhi Qi
A1 Jinzhen Cai
A1 Jiayin Yang
A1 Shusen Zheng
A1 Xiao Xu
YR 2024
UL http://www.cancerbiomed.org/content/early/2024/02/28/j.issn.2095-3941.2023.0453.abstract
AB Objective: Sex-specific differences are observed in various liver diseases, but the influence of sex on the outcomes of hepatocellular carcinoma (HCC) after liver transplantation (LT) remains to be determined. This study is the first Chinese nationwide investigation of the role of sex in post-LT outcomes in patients with HCC.Methods: Data for recipients with HCC registered in the China Liver Transplant Registry between January 2015 and December 2020 were analyzed. The associations between donor, recipient, or donor-recipient transplant patterns by sex and the post-LT outcomes were studied with propensity score matching (PSM). The survival associated with different sex-based donor-recipient transplant patterns was further studied.Results: Among 3,769 patients enrolled in this study, the 1-, 3-, and 5-year overall survival (OS) rates of patients with HCC after LT were 96.1%, 86.4%, and 78.5%, respectively, in female recipients, and 95.8%, 79.0%, and 70.7%, respectively, in male recipients after PSM (P = 0.009). However, the OS was comparable between recipients with female donors and male donors. Multivariate analysis indicated that male recipient sex was a risk factor for post-LT survival (HR = 1.381, P = 0.046). Among the donor-recipient transplant patterns, the male-male donor-recipient transplant pattern was associated with the poorest post-LT survival (P < 0.05).Conclusions: Our findings highlighted that the post-LT outcomes of female recipients were significantly superior to those of male recipients, and the male-male donor-recipient transplant pattern was associated with the poorest post-LT survival. Livers from male donors may provide the most benefit to female recipients. Our results indicate that sex should be considered as a critical factor in organ allocation.Data were generated by the authors and available on request.