Gender differences in heart transplantation. Twenty-five year trends in the nationwide spanish heart transplant registry
María Dolores García-Cosio 1 2 , Francisco González-Vilchez 3 , Raquel López-Vilella 4 , Eduardo Barge-Caballero 5 , Manuel Gómez Bueno 6 , Manuel Martínez-Selles 2 7 , Jose María Arizón 8 , Diego Rangel Sousa 9 , José González-Costello 10 , Sonia Mirabet 11 , Félix Pérez-Villa 12 , Beatriz Díaz Molina 13 , Gregorio Rábago 14 , Ana Portolés Ocampo 15 , Luis de, la Fuente Galan 16 , Iris Garrido 17 , Juan F Delgado Jiménez 1 2 18
The study of gender differences may lead into improvement in patient care. We have aimed to identify the gender differences in heart transplantation (HT) of adult HT recipients in Spain and their evolution in a study covering the years 1993-2017 in which 6740 HT (20.6% in women) were performed.
HT indication rate per million inhabitants was lower in women, remaining basically unchanged during the 25-year study period. HT rate was higher in men, although this decreased over the 25-year study period.
Type of heart disease differed in men vs. women (p<0.001): ischemic heart disease 47.6% vs 22.5%, dilated cardiomyopathy 41.3% vs 34.6% or other 36% vs 17.8%, respectively.
Men were more frequently diabetics (18 vs 13.1% p<0.001), hypertensives (33.1 vs 24% p<0.001) and smokers (21.7 vs 12.9% p<0.001), respectively. Women had more pre-HT malignancies (7.1 vs 2.8% p<0.001) and their clinical status was worse at HT due to renal function and mechanical ventilation.
Adjusted survival (p=0.198) and most of the mortality-related variables were similar in men and women. Death occurred more frequently in women due to rejection (7.9 vs 5.1% p<0.001) and primary failure (18.2 vs 12.5% p<0.001) and in men due to malignancies (15.1 vs 6.6% p<0.001).