Skip to main content

Advertisement

Log in

Gender of donor influences outcome after orthotopic liver transplantation in adults

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Because male and female livers not only differ with respect to estrogen and androgen receptor content, but also demonstrate sexual dimorphism of certain functions, we examined the effect of donor gender on graft survival following liver transplantation (OLTx) in adults. Between February 1981 and February 1988, 982 OLTx procedures were performed in 789 adult patients at the University of Pittsburgh. In this study, OLTx was categorized as a failure if the patient died or required retransplantation within 60 days of the surgery. When the donor-recipient gender combinations were male-male, male-female, and female-female, the failure rates were 28%, 28%, and 36%, respectively. In contrast, 60% of female donor livers failed in male recipients. Compared to the pooled donor-recipient gender combinations, the odds of failure for female-male liver grafts were increased 3.7-fold (95% confidence interval: 6.5, 2.1;P<0.001). These findings may result, at least in part, from alterations in the sex hormone milieu or changes in the graft estrogen or androgen receptor content.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Eisenfeld AJ, Aten R, Weinberger MJ, Haselbacher G, Halpern K: Estrogen receptor in mammalian liver. Science 191:862–865, 1976

    Google Scholar 

  2. Aten RF, Dickson RB, Eisenfeld AJ: Estrogen receptor in adult male rat liver. Endocrinology 103:1629–1635, 1978

    Google Scholar 

  3. Bannister P, Sheridan P, Losowsky MS: Identification and characterization of the human androgen receptor. Clin Endocrinol 23:495–502, 1985

    Google Scholar 

  4. Eagon PK, Fisher SE, Imhoff AF, Porter LE, Stewart RR, Van Thiel DH, Lester R: Estrogen-binding proteins of male rat liver: Influences of hormonal changes. Arch Biochem Biophys 201:486–499, 1980

    Google Scholar 

  5. Eagon PK, Porter LE, Francavilla A, Di Leo A, Van Thiel DH: Estrogen and androgen receptors in the liver: Their role in liver disease and regeneration. Semin Liver Dis 5:59–69, 1985

    Google Scholar 

  6. Roy AK, Chatterjee B: Sexual dimorphism in the liver. Annu Rev Physiol 45:37–50, 1983

    Google Scholar 

  7. Bardin CW, Catteral JS: Testosterone: A major determinant of extragenital sexual dimorphism. Science 211:1285–1294, 1981

    Google Scholar 

  8. Gustafsson JA, Mode A, Norstedt G, Skett P: Sex steroid induced changes in hepatic enzymes. Annu Rev Physiol 45:51–60, 1983

    Google Scholar 

  9. Starzl TE, Iwatsuki S, Van Thiel DH, Gartner JC, Zitelli BJ, Malatack JJ, Schade RR, Shaw BW Jr, Hakala TR, Rosenthal JT, Porter KA: Evolution of liver transplantation. Hepatology 2:614–636, 1982

    Google Scholar 

  10. Starzl TE, Iwatsuki S, Esquivel CO, Todd S, Kam I, Lynch S, Gordon RD, Shaw RW Jr: Refinements in the surgical technique of liver transplantation. Semin Liver Dis 5:349–356, 1985

    Google Scholar 

  11. Van Thiel DH, Schade R, Gavaler JS, Shaw BW Jr, Iwatsuki S, Starzl TE: Medical aspects of liver transplantation. Hepatology 4:795–835, 1984

    Google Scholar 

  12. Starzl TE, Weil R, Iwatsuki S, Klintmalm G, Schroeder GRJ, Koer LJ, Iwaki Y, Terasaki PI, Porter KA: The use of cyclosporin A and prednisone in cadaver kidney transplantation. Surg Gynecol Obstet 151:17–26, 1980

    Google Scholar 

  13. Fung JJ, Demetris AJ, Porter KA, Iwatsuki S, Gordon RD, Esquivel CO, Jaffe R, Shaw BW Jr, Starzl TE: The use of OKT3 with cyclosporine and steroids for reversal of acute kidney and liver allograft rejection. Nephron 96:19–33, 1987

    Google Scholar 

  14. Schlesselman JJ: Case Control Studies: Design, Conduction and Analysis. New York: Oxford University Press, 1982, pp 176–177

    Google Scholar 

  15. Fleiss J: Statisical Methods for Rates and Proportions, 2nd ed. New York, Jøhn Wieley & Sons, 1981, pp 56–75

    Google Scholar 

  16. Kahn D, Zeng P, Makowka L, Murose N, Nakajima Y, Eagan PK, Francavilla A, Starzl TE, Van Thiel DH: Orthotopic liver transplantation and the estrogen-androgen receptor status of the liver: The influence of the sex of the donor. Hepatology 10:861–866, 1989

    Google Scholar 

  17. Baum JK, Holtz F, Bookstein JJ, Klein EW: Possible association between benign hepatomas and oral contraceptives. Lancet 2:926–929, 1973

    Google Scholar 

  18. Klatskin G: Hepatic tumors: Possible relationship to use of oral contraceptives. Gastroenterology 73:386–394, 1977

    Google Scholar 

  19. Stoll BA, Andrews JT, Matterus R: Liver damage from oral contraceptives. Br Med J 1:960–961, 1966

    Google Scholar 

  20. Kern F: Effect of estrogens on the liver. Gastroenterology 75:512–522, 1978

    Google Scholar 

  21. Porter LE, Elm MS, Van Thiel DH, Eagon PK: Estrogen receptor in human liver nuclei. Hepatology 4:1085, 1984

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Supported by Research Grants from the Veterans Administration, Project Grant DK 29961 and by grants AA06601 and AA06772 from the National Institute on Alcohol Abuse and Alcoholism. Dr. D. Kahn was supported by a grant from the Medical Research Council of South Africa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kahn, D., Gavaler, J.S., Makowka, L. et al. Gender of donor influences outcome after orthotopic liver transplantation in adults. Digest Dis Sci 38, 1485–1488 (1993). https://doi.org/10.1007/BF01308608

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01308608

Key Words

Navigation