Introduction: Many studies have shown a detrimental effect of female donor gender on heart transplantation (HT) outcome.
Objective: We retrospectively evaluated our experience in HT to determine the effect of donor gender on early survival.
Materials and methods: We divided the sample of 464 primary HT from November 1997 to September 2006 into 4 groups: G1, female donor to a male recipient; G2, male donor to a male recipient; G3, male donor to female recipient; and G4, female donor to a female recipient. We performed a descriptive study of the baseline characteristics. The chi(2) test was used to determine differences in early mortality (30 days) between groups and a multivariate analysis to identify confounding factors to increase mortality.
Results: Although the univariate study showed that G1 showed a significantly lower early survival rate (84%) than G2 (91%), the multivariate study adjusted for donor and recipient weight and size, urgency level, previous surgery, and age only showed urgency level (odds ratio [OR] 2.6; 95% confidence interval [CI] 1.2-5.57; P = .016) and previous surgery (OR 5.8; 95% CI 2.7-12.4; P < .01) to be predictors of early mortality. When baseline characteristics were analyzed, we found that 31% of HT in G1 were urgent versus 18% in G2, and 32% of patients in G1 had previous surgery versus 17% in G2.
Conclusions: Donor gender did not appear to negatively affect early survival. In our series, urgent HT in male recipients with a female was more frequent than with a male donor heart. The higher early mortality in male recipients of an urgent HT from a female than from a male donor was attributable to a higher baseline risk profile.