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Sex-mismatch influence on survival after heart transplantation: A systematic review and meta-analysis of observational studies.
Clin Transplant 2019; :e13737CT

Abstract

INTRODUCTION AND OBJECTIVES

Heart transplantation (HT) is the treatment for patients with end-stage heart disease. Despite contradictory reports, survival seems to be worse when donor/recipient sex is mismatched. This systematic review and meta-analysis aims to synthesize the evidence on the effect of donor/recipient sex mismatch after HT.

METHODS

We searched PubMed and EMBASE until November 2017. Comparative cohort and registry studies were included. Published articles were systematically selected and, when possible, pooled in a meta-analysis. The primary endpoint was one-year mortality.

RESULTS

After retrieving 556 articles, ten studies (76 175 patients) were included in the quantitative meta-analysis. Significant differences were found in one-year survival between sex-matched and mismatched recipients (odds ratio (OR) 1.30, 95% confidence interval (CI) 1.25-1.35, P < .001). In female recipients, we found that sex mismatch was not a risk factor for one-year mortality (OR = 0.93, 95% CI = 0.85-1.00, P = .06). However, in male recipients, we found that it was a risk factor for one-year mortality (OR = 1.38, 95% CI = 1.31-1.44, P < .001).

CONCLUSIONS

Sex mismatch increases one-year mortality after HT in male recipients. Its influence in long-term survival should be further explored with high-quality studies.

Authors+Show Affiliations

Servicio de cardiología, Hospital Universitario Central de Asturias, Oviedo, Spain.Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain. CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. Centro Iberoamericano Cochrane, Barcelona, Spain.Centro Iberoamericano Cochrane, Barcelona, Spain. Centro de Investigación Biomédica, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile. Centro Interdisciplinar para Estudios de la Salud, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile.Centro Iberoamericano Cochrane, Barcelona, Spain.Servicio de Cardiología, Hospital Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERCV, Madrid, Spain. Universidad Complutense de Madrid, Madrid, Spain.Servicio de Cardiología, Hospital Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERCV, Madrid, Spain. Universidad Complutense de Madrid, Madrid, Spain. Universidad Europea de Madrid, Madrid, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31630456

Citation

Ayesta, Ana, et al. "Sex-mismatch Influence On Survival After Heart Transplantation: a Systematic Review and Meta-analysis of Observational Studies." Clinical Transplantation, 2019, pp. e13737.
Ayesta A, Urrútia G, Madrid E, et al. Sex-mismatch influence on survival after heart transplantation: A systematic review and meta-analysis of observational studies. Clin Transplant. 2019.
Ayesta, A., Urrútia, G., Madrid, E., Vernooij, R. W. M., Vicent, L., & Martínez-Sellés, M. (2019). Sex-mismatch influence on survival after heart transplantation: A systematic review and meta-analysis of observational studies. Clinical Transplantation, pp. e13737. doi:10.1111/ctr.13737.
Ayesta A, et al. Sex-mismatch Influence On Survival After Heart Transplantation: a Systematic Review and Meta-analysis of Observational Studies. Clin Transplant. 2019 Oct 20;e13737. PubMed PMID: 31630456.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sex-mismatch influence on survival after heart transplantation: A systematic review and meta-analysis of observational studies. AU - Ayesta,Ana, AU - Urrútia,Gerard, AU - Madrid,Eva, AU - Vernooij,Robin W M, AU - Vicent,Lourdes, AU - Martínez-Sellés,Manuel, Y1 - 2019/10/20/ PY - 2019/07/05/received PY - 2019/10/03/revised PY - 2019/10/08/accepted PY - 2019/10/21/pubmed PY - 2019/10/21/medline PY - 2019/10/21/entrez KW - heart transplantation KW - meta-analysis KW - mismatch KW - prognosis KW - sex SP - e13737 EP - e13737 JF - Clinical transplantation JO - Clin Transplant N2 - INTRODUCTION AND OBJECTIVES: Heart transplantation (HT) is the treatment for patients with end-stage heart disease. Despite contradictory reports, survival seems to be worse when donor/recipient sex is mismatched. This systematic review and meta-analysis aims to synthesize the evidence on the effect of donor/recipient sex mismatch after HT. METHODS: We searched PubMed and EMBASE until November 2017. Comparative cohort and registry studies were included. Published articles were systematically selected and, when possible, pooled in a meta-analysis. The primary endpoint was one-year mortality. RESULTS: After retrieving 556 articles, ten studies (76 175 patients) were included in the quantitative meta-analysis. Significant differences were found in one-year survival between sex-matched and mismatched recipients (odds ratio (OR) 1.30, 95% confidence interval (CI) 1.25-1.35, P < .001). In female recipients, we found that sex mismatch was not a risk factor for one-year mortality (OR = 0.93, 95% CI = 0.85-1.00, P = .06). However, in male recipients, we found that it was a risk factor for one-year mortality (OR = 1.38, 95% CI = 1.31-1.44, P < .001). CONCLUSIONS: Sex mismatch increases one-year mortality after HT in male recipients. Its influence in long-term survival should be further explored with high-quality studies. SN - 1399-0012 UR - https://www.unboundmedicine.com/medline/citation/31630456/Sex-mismatch_influence_on_survival_after_heart_transplantation._A_systematic_review_and_meta-analysis_of_observational_studies L2 - https://doi.org/10.1111/ctr.13737 DB - PRIME DP - Unbound Medicine ER -