首页|Influence of sex on outcomes of liver transplantation for hepatocellular carcinoma:a multicenter cohort study in China

Influence of sex on outcomes of liver transplantation for hepatocellular carcinoma:a multicenter cohort study in China

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Objective:Sex-specific differences are observed in various liver diseases,but the influence of sex on the outcomes of hepatocellular carcinoma(HCC)after liver transplantation(LT)remains to be determined.This study is the first Chinese nationwide investigation of the role of sex in post-LT outcomes in patients with HCC.Methods:Data for recipients with HCC registered in the China Liver Transplant Registry between January 2015 and December 2020 were analyzed.The associations between donor,recipient,or donor-recipient transplant patterns by sex and the post-LT outcomes were studied with propensity score matching(PSM).The survival associated with different sex-based donor-recipient transplant patterns was further studied.Results:Among 3,769 patients enrolled in this study,the 1-,3-,and 5-year overall survival(OS)rates of patients with HCC after LT were 96.1%,86.4%,and 78.5%,respectively,in female recipients,and 95.8%,79.0%,and 70.7%,respectively,in male recipients after PSM(P = 0.009).However,the OS was comparable between recipients with female donors and male donors.Multivariate analysis indicated that male recipient sex was a risk factor for post-LT survival(HR = 1.381,P = 0.046).Among the donor-recipient transplant patterns,the male-male donor-recipient transplant pattern was associated with the poorest post-LT survival(P<0.05).Conclusions:Our findings highlighted that the post-LT outcomes of female recipients were significantly superior to those of male recipients,and the male-male donor-recipient transplant pattern was associated with the poorest post-LT survival.Livers from male donors may provide the most benefit to female recipients.Our results indicate that sex should be considered as a critical factor in organ allocation.

Sexliver transplantationhepatocellular carcinomaoutcomerecipientdonor

Jian Chen、Zhe Yang、Fengqiang Gao、Zhisheng Zhou、Junli Chen、Di Lu、Kai Wang、Meihua Sui、Zhengxin Wang、Wenzhi Guo、Guoyue Lyu、Haizhi Qi、Jinzhen Cai、Jiayin Yang、Shusen Zheng、Xiao Xu

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Zhejiang University School of Medicine,Hangzhou 310030,China

Institute of Organ Transplantation,Zhejiang University,Hangzhou 310030,China

Department of Hepatobiliary and Pancreatic Surgery,Shulan Hospital of Hangzhou,Hangzhou 310006,China

National Center for Healthcare Quality Management in Liver Transplant,Hangzhou 310003,China

Department of General Surgery,Huashan Hospital,Fudan University,Shanghai 200040,China

Department of Hepatobiliary and Pancreatic Surgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China

Department of Hepatobiliary and Pancreatic Surgery,The First Hospital of Jilin University,Changchun 130021,China

Department of Liver Transplantation,Second Xiangya Hospital,Central South University,Changsha 410008,China

Department of Organ Transplantation Center,The Affiliated Hospital of Qingdao University,Qingdao 266003,China

Department of Liver Surgery and Liver Transplantation Center,West China Hospital,Sichuan University,Chengdu 610044,China

NHC Key Laboratory of Combined Multi-organ Transplantation,Hangzhou 310003,China

Department of Hepatobiliary and Pancreatic Surgery,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China

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国家重点研发计划国家自然科学基金重大项目国家自然科学基金重点项目国家自然科学基金浙江省自然科学基金Key Research&Development Program of Zhejiang ProvinceKey Research&Development Program of Zhejiang ProvinceKey Research&Development Program of Zhejiang Province

2021YFA1100500921592028193001682300743LQ23H1600442019C030502022C031082021C03118

2024

10.20892/j.issn.2095-3941.2023.0453

癌症生物学与医学(英文版)
中国抗癌协会

癌症生物学与医学(英文版)

CSTPCD
影响因子：1.07
ISSN：2095-3941
年,卷(期)：2024.21(4)
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