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Mortality and Causes of Death After Liver Transplantation: Analysis of Sex Differences in a Large Nationwide Cohort

In the last few years, several studies have analyzed sex and gender differences in liver transplantation (LT), but none have performed a disaggregated analysis of both mortality and causes of death. Data from 15,998 patients, 11,914 (74.5%) males and 4,069 (25.5%) females, transplanted between 2000...

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Autores principales: Serrano, M. Trinidad, Sabroso, Sergio, Esteban, Luis M., Berenguer, Marina, Fondevila, Constantino, Lorente, Sara, Cortés, Luis, Sanchez-Antolin, Gloria, Nuño, Javier, De la Rosa, Gloria, Salcedo, Magdalena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9124758/
https://www.ncbi.nlm.nih.gov/pubmed/35615539
http://dx.doi.org/10.3389/ti.2022.10263
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author Serrano, M. Trinidad
Sabroso, Sergio
Esteban, Luis M.
Berenguer, Marina
Fondevila, Constantino
Lorente, Sara
Cortés, Luis
Sanchez-Antolin, Gloria
Nuño, Javier
De la Rosa, Gloria
Salcedo, Magdalena
author_facet Serrano, M. Trinidad
Sabroso, Sergio
Esteban, Luis M.
Berenguer, Marina
Fondevila, Constantino
Lorente, Sara
Cortés, Luis
Sanchez-Antolin, Gloria
Nuño, Javier
De la Rosa, Gloria
Salcedo, Magdalena
author_sort Serrano, M. Trinidad
collection PubMed
description In the last few years, several studies have analyzed sex and gender differences in liver transplantation (LT), but none have performed a disaggregated analysis of both mortality and causes of death. Data from 15,998 patients, 11,914 (74.5%) males and 4,069 (25.5%) females, transplanted between 2000 and 2016 were obtained from the Liver Transplantation Spanish Registry. Survival analysis was applied to explore recipient sex as a risk factor for death. The causes of death at different follow-up duration were disaggregated by recipient sex for analysis. Short-term survival was higher in males, whereas long-term survival was higher in females. Survival at 1, 5 and 10 years post-transplant was 87.43%, 73.83%, and 61.23%, respectively, in males and 86.28%, 74.19%, and 65.10%, respectively, in females (p = 0.05). Post-LT mortality related to previous liver disease also presented sex differences. Males had 37% increased overall mortality from acute liver failure (p = 0.035) and 37% from HCV-negative cirrhosis (p < 0.001). Females had approximately 16% increased mortality when the liver disease was HCV-positive cirrhosis (p = 0.003). Regarding causes of death, non-malignancy HCV+ recurrence (6.3% vs. 3.9% of patients; p < 0.001), was more frequently reported in females. By contrast, death because of malignancy recurrence (3.9% vs. 2.2% of patients; p = 0.003) and de novo malignancy (4.8% vs. 2.5% of patients; p < 0.001) were significantly more frequent in male recipients. Cardiovascular disease, renal failure, and surgical complications were similar in both. In summary, male patients have lower short-term mortality than females but higher long-term and overall mortality. In addition, the post-LT mortality risk related to previous liver disease and the causes of mortality differ between males and females.
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spelling pubmed-91247582022-05-24 Mortality and Causes of Death After Liver Transplantation: Analysis of Sex Differences in a Large Nationwide Cohort Serrano, M. Trinidad Sabroso, Sergio Esteban, Luis M. Berenguer, Marina Fondevila, Constantino Lorente, Sara Cortés, Luis Sanchez-Antolin, Gloria Nuño, Javier De la Rosa, Gloria Salcedo, Magdalena Transpl Int Health Archive In the last few years, several studies have analyzed sex and gender differences in liver transplantation (LT), but none have performed a disaggregated analysis of both mortality and causes of death. Data from 15,998 patients, 11,914 (74.5%) males and 4,069 (25.5%) females, transplanted between 2000 and 2016 were obtained from the Liver Transplantation Spanish Registry. Survival analysis was applied to explore recipient sex as a risk factor for death. The causes of death at different follow-up duration were disaggregated by recipient sex for analysis. Short-term survival was higher in males, whereas long-term survival was higher in females. Survival at 1, 5 and 10 years post-transplant was 87.43%, 73.83%, and 61.23%, respectively, in males and 86.28%, 74.19%, and 65.10%, respectively, in females (p = 0.05). Post-LT mortality related to previous liver disease also presented sex differences. Males had 37% increased overall mortality from acute liver failure (p = 0.035) and 37% from HCV-negative cirrhosis (p < 0.001). Females had approximately 16% increased mortality when the liver disease was HCV-positive cirrhosis (p = 0.003). Regarding causes of death, non-malignancy HCV+ recurrence (6.3% vs. 3.9% of patients; p < 0.001), was more frequently reported in females. By contrast, death because of malignancy recurrence (3.9% vs. 2.2% of patients; p = 0.003) and de novo malignancy (4.8% vs. 2.5% of patients; p < 0.001) were significantly more frequent in male recipients. Cardiovascular disease, renal failure, and surgical complications were similar in both. In summary, male patients have lower short-term mortality than females but higher long-term and overall mortality. In addition, the post-LT mortality risk related to previous liver disease and the causes of mortality differ between males and females. Frontiers Media S.A. 2022-05-09 /pmc/articles/PMC9124758/ /pubmed/35615539 http://dx.doi.org/10.3389/ti.2022.10263 Text en Copyright © 2022 Serrano, Sabroso, Esteban, Berenguer, Fondevila, Lorente, Cortés, Sanchez-Antolin, Nuño, De la Rosa and Salcedo. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Archive
Serrano, M. Trinidad
Sabroso, Sergio
Esteban, Luis M.
Berenguer, Marina
Fondevila, Constantino
Lorente, Sara
Cortés, Luis
Sanchez-Antolin, Gloria
Nuño, Javier
De la Rosa, Gloria
Salcedo, Magdalena
Mortality and Causes of Death After Liver Transplantation: Analysis of Sex Differences in a Large Nationwide Cohort
title Mortality and Causes of Death After Liver Transplantation: Analysis of Sex Differences in a Large Nationwide Cohort
title_full Mortality and Causes of Death After Liver Transplantation: Analysis of Sex Differences in a Large Nationwide Cohort
title_fullStr Mortality and Causes of Death After Liver Transplantation: Analysis of Sex Differences in a Large Nationwide Cohort
title_full_unstemmed Mortality and Causes of Death After Liver Transplantation: Analysis of Sex Differences in a Large Nationwide Cohort
title_short Mortality and Causes of Death After Liver Transplantation: Analysis of Sex Differences in a Large Nationwide Cohort
title_sort mortality and causes of death after liver transplantation: analysis of sex differences in a large nationwide cohort
topic Health Archive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9124758/
https://www.ncbi.nlm.nih.gov/pubmed/35615539
http://dx.doi.org/10.3389/ti.2022.10263
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