Ann Surg Treat Res.  2023 Sep;105(3):133-140. 10.4174/astr.2023.105.3.133.

Donor sex and donor-recipient sex disparity do not affect hepatocellular carcinoma recurrence after living donor liver transplantation

• Oh RK
• Hwang S
• Song GW
• Ahn CS
• Moon DB
• Ha TY
• Jung DH
• Park GC
• Yoon YI
• Kang WH

• KMID: 2545904
• DOI: http://doi.org/10.4174/astr.2023.105.3.133

Abstract

Purpose
Studies have yielded contradictory results on whether donor sex and donor-recipient sex disparity affect hepatocellular carcinoma (HCC) recurrence after living donor liver transplantation (LDLT). The present study assessed whether donor sex or donor-recipient sex disparity affects HCC recurrence after LDLT at a high-volume center.
Methods
This study included 772 HCC patients who underwent LDLT between January 2006 and December 2015 at Asan Medical Center. Patients were divided into 4 groups based on the sex of the donor and recipient: male-to-male (n = 490, 63.5%), male-to-female (n = 75, 9.7%), female-to-male (n = 170, 22.0%), and female-to-female (n = 37, 4.8%).
Results
Disease-free survival (DFS; P = 0.372) and overall survival (OS; P = 0.591) did not differ significantly among the 4 groups. DFS also did not differ significantly between LDLT recipients with male and female donors (P = 0.792) or between male and female recipients (P = 0.084). After patient matching with an α-FP/des-γ-carboxy prothrombin/tumor volume score cutoff of 5logs, donor-recipient sex disparity did not significantly affect DFS (P = 0.598) or OS (P = 0.777). There were also no differences in DFS in matched LDLT recipients with male and female donors (P = 0.312) or between male and female recipients (P = 0.374).
Conclusion
Neither donor sex nor donor-recipient sex disparity significantly affected posttransplant HCC recurrence.

Keyword

Androgens; Donor selection; Donor sex; Hepatocellular carcinoma; Sex disparity

Figure

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  Fig. 1 Kaplan-Meier analysis of (A) disease-free survival (DFS) and (B) overall survival (OS) in all 772 patients who underwent living donor liver transplantation for hepatocellular carcinoma. Comparisons by log-rank tests.

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  Fig. 2 Kaplan-Meier analysis of (A) disease-free survival (DFS) and (B) overall survival (OS) curves in all 772 patients according to sex matching of the donor and recipient. Comparisons by log-rank tests. MM, male-to-male; MF, male-to-female; FM, female-to-male; FF, female-to-female.

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  Fig. 3 Kaplan-Meier analysis of disease-free survival (DFS) and overall survival (OS) in all 772 patients according to the sex of the donor (A and B) and recipient (C and D). Comparisons by log-rank tests.

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  Fig. 4 Kaplan-Meier analysis of (A) disease-free survival (DFS) and (B) overall survival (OS) in the 590 patients with ADV scores of <5log according to sex matching of the donor and recipient. Comparisons by log-rank tests. MM, male-to-male; MF, male-to-female; FM, female-to-male; FF, female-to-female; ADV, multiplication of α-FP, des-γ-carboxy prothrombin, and tumor volume.

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  Fig. 5 Kaplan-Meier analysis of disease-free survival (DFS) and overall survival (OS) in the 590 patients with ADV score of <5log according to the sex of the donor (A and B) and recipient (C and D). Comparisons by log-rank tests. ADV, multiplication of α-FP, des-γ-carboxy prothrombin, and tumor volume.

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