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Sex differences in preformed panel‐reactive antibody levels and outcomes in patients undergoing heart transplantation
Author(s) -
Magnussen Christina,
Ruebsamen Nicole,
Ojeda Francisco M.,
Rybczynski Meike,
Kobashigawa Jon,
Reichenspurner Hermann,
Bernhardt Alexander M.,
Schnabel Renate B.
Publication year - 2019
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13572
Subject(s) - medicine , hazard ratio , panel reactive antibody , heart transplantation , confidence interval , transplantation , prospective cohort study , cardiology , surgery , kidney transplantation
Background Sex differences in panel‐reactive antibody (PRA) levels in heart transplant recipients and their association with transplant‐related outcomes are mostly unknown. Methods In 20 181 (24.7% women) first‐time heart transplant recipients included from July 2004 to March 2015 in the prospective Organ Procurement and Transplantation Network (OPTN), we studied sex differences in most recent (mr) and peak (p)PRA and outcomes (graft failure, rejection, cardiac allograft vasculopathy [CAV], retransplantation, and mortality). Median follow‐up (all‐cause mortality) was 6 years. Analyses are based on OPTN data (March 6, 2017). Results MrPRA levels were associated with all‐cause mortality (hazard ratio, 95% confidence interval: class I 1.03, 1.01‐1.04, P < 0.001) and acute rejection (class II 1.08, 1.03‐1.14, P = 0.0044). PPRA levels were associated with all‐cause mortality (class I 1.02, 1.00‐1.04, P = 0.015) and CAV (class II 1.03, 1.01‐1.06, P = 0.020). Sex interactions were seen for the association of pPRA and graft failure with a higher risk in women, and for pPRA and CAV with a higher risk in men. Conclusions PRA were associated with different transplant‐related outcomes in both sexes. However, women with elevated pPRA were shown to be at higher risk for graft failure, whereas higher levels of pPRA were more hazardous for men in developing CAV.