Meta-Analysis
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 28, 2018; 24(20): 2203-2210
Published online May 28, 2018. doi: 10.3748/wjg.v24.i20.2203
Donor-to-recipient gender match in liver transplantation: A systematic review and meta-analysis
Quirino Lai, Francesco Giovanardi, Fabio Melandro, Zoe Larghi Laureiro, Manuela Merli, Barbara Lattanzi, Redan Hassan, Massimo Rossi, Gianluca Mennini
Quirino Lai, Francesco Giovanardi, Fabio Melandro, Zoe Larghi Laureiro, Redan Hassan, Massimo Rossi, Gianluca Mennini, Hepato-bilio-pancreatic and Liver Transplant Unit, Department of Surgery, Sapienza University of Rome, Rome 00161, Italy
Manuela Merli, Barbara Lattanzi, Division of Gastroenterology, Department of Clinical Medicine, Sapienza University of Rome, Rome 00161, Italy
Author contributions: Lai Q makes contribution to conception and design of the study, acquisition of data, analysis and interpretation of data, drafting the article, and final approval; Giovanardi F makes contribution to acquisition of data, analysis and interpretation of data, final approval; Melandro F, Larghi Laureiro Z, Lattanzi B, and Hassan R make contribution to acquisition of data, final approval; Merli M, Rossi M, and Mennini G make contribution to critical revision, final approval.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Quirino Lai, MD, PhD, Academic Fellow, Academic Research, Assistant Lecturer, Doctor, Senior Lecturer, Hepato-bilio-pancreatic and Liver Transplant Unit, Department of Surgery, Sapienza University of Rome, Umberto I Policlinic of Rome, Viale del Policlinico 155, Rome 00161, Italy. lai.quirino@libero.it
Telephone: +39-3493020126 Fax: +39-6499701
Received: March 22, 2018
Peer-review started: March 22, 2018
First decision: March 30, 2018
Revised: March 30, 2018
Accepted: May 18, 2018
Article in press: May 18, 2018
Published online: May 28, 2018
Processing time: 67 Days and 1.9 Hours
Abstract
AIM

To perform a systematic review and meta-analysis on donor-to-recipient gender mismatch as a risk factor for post-transplant graft loss.

METHODS

A systematic literature search was performed using PubMed, Cochrane Library database and EMBASE. The primary outcome was graft loss after liver transplantation. Odds ratios and 95% confidence intervals were calculated to compare the pooled data between groups with different donor-to-recipient gender matches. Three analyses were done considering (1) gender mismatches (F-M and M-F) vs matches (M-M and F-F); (2) Female-to-Male mismatch vs other matches; and (3) Male-to-Female mismatch vs other matches.

RESULTS

A total of 7 articles were analysed. Gender mismatch (M-F and F-M) was associated with a significant increase of graft loss respect to match (M-M and F-F) (OR: 1.30; 95%CI: 1.13-1.50; P < 0.001). When F-M mismatch was specifically investigated, it confirmed its detrimental role in terms of graft survival (OR: 1.83; 95%CI: 1.20-2.80; P = 0.005). M-F mismatch failed to present a significant role (OR: 1.09; 95%CI: 0.73-1.62; P = 0.68).

CONCLUSION

Gender mismatch is a risk factor for poor graft survival after liver transplantation. Female-to-male mismatch represents the worst combination. More studies are needed with the intent to better clarify the reasons for these results.

Keywords: Graft survival; Female-to-male mismatch; Liver transplantation; Donor-to-recipient match; Gender

Core tip: Limited data exist on the role of donor-to-recipient gender mismatch after liver transplantation. This is the first systematic review and meta-analysis specifically investigating the role of gender match in the setting of liver transplant. Female-to-male mismatch was a risk factor for graft loss, with a 83-fold increased risk.