Lung transplantation and gender effects on survival of recipients with cystic fibrosis

Purpose The overall life expectancy of Cystic Fibrosis (CF) women is shorter than CF men without accounting for lung transplant recipients. However, it is unclear how donor and recipient gender will impact long term outcomes in CF patients who undergo lung transplantation. Therefore, the purpose of this study is to determine if the gender disadvantage seen in women with CF pre-transplant continues to exist post-lung transplant and if this is impacted by donor gender. Methods CF patients entered in the International Society for Heart and Lung Transplantation (ISHLT) registry, who were at least 18 years old and received a lung transplant between January 2000 and December 2012 were included and divided into groups based on donor-recipient gender combinations. Kaplan-Meier curves were used to determine rates of overall survival and bronchiolitis obliterans syndrome (BOS)-free time post-transplant. results 4,971 patients undergoing lung transplantation for CF were included in the analysis. There was no significant difference in BOS-free survival or overall survival rates between genders, or between gender-matched versus mismatched recipients after lung transplantation. However, females with CF were transplanted at a younger age and died at an earlier overall age than males with CF. Conclusions Survival after lung transplantation and time to the development of BOS did not differ based on gender or donor-recipient gender combination. However, CF females continue to demonstrate a poorer overall life expectancy as their pre-transplant disadvantage could not be overcome after lung transplantation.