Clinical data may be suggestive for differences in patient survival in gender-incompatible orthotopic liver transplantation.
However, findings are inconsistent and are putatively linked to circulating hormones.
Dr Frank Lehner and colleagues from Germany investigated patient survival as well as metabolism of steroids to identify possible causes of improved graft survival in gender-mismatched orthotopic liver transplantation.
The team examined their single-center database of 1355 recipients of first liver transplants for overall patient survival by non-parametric and parametric analysis of multivariance.
|The metabolism of testosterone did not differ between male and female hepatocyte cultures|
The research team took into account the age of recipient and donor, ischemia time, underlying liver disease and the time period of transplantation.
Furthermore, the metabolism of androgens in gender-incompatible orthotopic liver transplantation was studied in cultures of primary human hepatocytes obtained from male and female patients.
Unlike previous studies, the research team were unable to determine overall significant differences in patient survival in gender-incompatible orthotopic liver transplantation.
Even though a statistically significant improved patient survival was observed when male donor livers were transplanted into female recipients in univariant analysis.
However, when the overall patient management was taken into account no difference in survival was determined in multivariant analysis.
Importantly, the metabolism of testosterone did not differ between male and female hepatocyte cultures, except for the production of 6-a-hydroxy-testosterone.
Dr Lehner’s team concluded, “Taken collectively, clinical observations may tend to suggest a slightly improved patient survival in gender-incompatible orthotopic liver transplantation.”
“However, this cannot be explained on the bases of androgen metabolism.”
“Overall, we view gender-incompatible liver transplantation not to be a confounder in patient survival after orthotopic liver transplantation.”