Impact of sex on the outcomes of deceased donor liver transplantation

Table 1 Descriptive variables stratified by recipient sex, n (%)

	Male	Female	P value
	518 (66.5)	261 (33.5)
Donor sex			0.001
Male	326 (62.9)	59 (22.6)
Female	192 (37.1)	202 (77.4)
Etiology			0.001
Acute liver failure	18 (3.5)	34 (13.0)
Alcohol	149 (28.8)	46 (17.6)
HBV/HCV	160 (30.9)	53 (20.3)
HCC	152 (29.3)	45 (17.2)	0.001
NASH	58 (11.2)	20 (7.7)
PSC	53 (10.2)	12 (4.6)
Others1	80 (15.4)	96 (36.8)
Milan criteria
HCC within Milan	132 (86.8)	39 (86.7)	0.9756
HCC beyond Milan	20 (13.2)	6 (13.3)
Comorbidities	364 (70.3)	162 (62.1)	0.021
Coronary artery disease	83 (16.0)	25 (9.6)	0.014
Diabetes	140 (27.0)	41 (15.7)	0.001
Peripheral vascular disease	5 (1.0)	2 (0.8)	0.781
COPD	75 (14.5)	33 (12.6)	0.484
Smoker	131 (25.3)	49 (18.8)	0.042
High urgency transplant	25 (4.8)	41 (15.7)	0.001
Intraoperative blood transfusion	217 (41.9)	115 (44.1)	0.563
Perioperative death	89 (17.2)	39 (14.9)	0.426

¹Hepatopulmonary syndrome, hyperoxaluria, polycystic liver disease, hepatoblastoma, Budd Chiari, neuroendocrine tumor, Wilson’s disease, primary biliary cirrhosis, autoimmune hepatitis, cryptogenic. COPD: Chronic obstructive pulmonary disease; HBV: Hepatitis B virus; HCC: Hepatocellular carcinoma; HCV: Hepatitis C virus; NASH: Non-alcoholic steatohepatitis; PSC: Primary sclerosing cholangitis.

Table 2 Numerical variables stratified by recipient sex

	Male	Female	P value
	Median [25%-75%]	Median [25%-75%]
Age at time of listing	54 [47-59]	51 [43-59]	0.019
BMI (kg/m²)	26.3 [23.46-29.41]	24.38 [21.72-28.7]	0.001
Comorbidity Index	33.5 [0-63.8]	33.5 [0-58.1]	0.84
Lab MELD	15 [11-21]	16 [12-24]	0.052
Wait list time (d)	78 [23-206]	61 [7-220]	0.094
Match MELD	25 [22-28]	25 [22-28]	0.598
Age at time of transplant	54 [48-60]	52 [44-59]	0.039
Donor age	58 [49-70]	61 [46-73]	0.781
DRI	1.706 [1.432-1.962]	1.837 [1.528-2.078]	0.001
CIT (min)	450 [370-530]	445 [382-521]	0.741
WIT (min)	30 [26-36]	28 [25-32]	0.001
Duration of surgery (min)	249 [209-302]	229 [190-286]	0.001
ICU stay (d)	5 [3-10]	5 [3-9]	0.571
Hospital stay (d)	19 [15-26]	19 [15-29]	0.317

BMI: Body mass index; CIT: Cold ischemic time; DRI: Donor risk index; ICU: Intensive care unit; MELD: Model for End-stage Liver Disease; WIT: Warm ischemic time.

Table 3 Multivariate analysis of variables associated with overall survival according to recipient sex

	Male		Female
	HR (95%CI)	P value	HR (95%CI)	P value
HCC	1.6 (1.11-2.3)	0.011	1.71 (0.81-3.64)	0.161
Age at time of listing	1.02 (1-1.04)	0.014	1.02 (0.99-1.05)	0.116
Comorbidity Index	1.04 (1.03-1.04)	0.001	1.04 (1.03-1.05)	0.001
Lab MELD	1.01 (0.99-1.04)	0.302	1.05 (1.02-1.08)	0.004
High urgency	2.87 (1.48-5.57)	0.002	0.84 (0.39-1.8)	0.656
Trauma (cause of death, donor)	1.32 (0.71-2.45)	0.384	3.05 (1.05-8.85)	0.04
Duration of surgery (min)	1 (1-1)	0.013	1 (1-1.01)	0.2
Units transfused	1.04 (1-1.09)	0.043	1.04 (0.95-1.13)	0.439

HCC: Hepatocellular carcinoma; MELD: Model for End-stage Liver Disease.