{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:22:27Z","timestamp":1791390147545,"version":"4.3.3"},"reference-count":14,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T00:00:00Z","timestamp":1662940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Available literature indicates the possible detrimental effect of sex mismatching on mortality in patients undergoing heart transplantation. Our objective was to examine the role of sex and heart mass (predicted heart mass [PHM]) mismatch on mortality and graft rejection in patients undergoing heart transplantation in the US.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data on adult patients who underwent heart transplantation between January 2015 and October 2021 were queried from the United Network of Organ Sharing (UNOS) registry. The main outcomes were all\u2010cause mortality, 1\u2010year all\u2010cause mortality and treated acute rejection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 19\u00a0805 adult patients underwent heart transplant during the study period. 92.2% of the patients in the female graft to male group had a PHM mismatch &lt;25%, while only 38.5% had such a mismatch in the male graft to female group. In male to male and female to female groups, 79% and 76% of the patients had a PHM mismatch &lt;25% (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.122). Proportion of PHM mismatch was similar throughout the study period. Unadjusted analysis showed that male recipients of female grafts had increased risk for all\u2010cause mortality (hazard ratio [HR]: 1.13; 95% confidence intervals [CI]: 1.02, 1.27; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.026) and 1\u2010year mortality (HR: 1.26; 95% CI: 1.09, 1.45; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.002) compared to male recipients of male grafts. Graft failure incidence was also higher (HR: 1.12; 95% CI: 1.01, 1.25; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.041). However, all these associations were non\u2010 significant after risk factor adjustment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sex mismatching is associated with post\u2010transplant mortality with transplantation of female donor grafts to male recipients demonstrating worse outcomes, although this association disappears after risk factor adjustment. Further research is required to elucidate the need for potential changes in clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14804","type":"journal-article","created":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T06:23:47Z","timestamp":1661408627000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Sex mismatch following heart transplantation in the United States: Characteristics and impact on outcomes"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4128-7111","authenticated-orcid":false,"given":"Ilias P.","family":"Doulamis","sequence":"first","affiliation":[{"name":"Department of Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aspasia","family":"Tzani","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Heart and Vascular Center Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Kourek","sequence":"additional","affiliation":[{"name":"National Kapodistrian University of Athens  Zografou Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8352-5360","authenticated-orcid":false,"given":"Polydoros N.","family":"Kampaktsis","sequence":"additional","affiliation":[{"name":"Division of Cardiology New York Presbyterian Hospital Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chakradhari","family":"Inampudi","sequence":"additional","affiliation":[{"name":"Division of Cardiology Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Kilic","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5740-9670","authenticated-orcid":false,"given":"Alexandros","family":"Briasoulis","sequence":"additional","affiliation":[{"name":"National Kapodistrian University of Athens  Zografou Greece"},{"name":"Division of Cardiovascular Medicine Section of Heart failure and Transplantation University of Iowa  Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.121.318172"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/FCVM.2021.617062"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.108.844183"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.HEALUN.2012.02.005"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1034\/J.1600\u20106143.2002.20608.X"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.HEALUN.2011.03.018"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.TRANSPROCEED.2009.06.098"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890\u2010199108000\u201000012"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ATHORACSUR.2011.02.086"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/TRI.12488"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735\u20101097(02)01712\u20106"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003\u20104975(96)00626\u20101"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.HEALUN.2005.06.003"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2018.09.017"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.14804","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ctr.14804","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.14804","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T23:04:19Z","timestamp":1692572659000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.14804"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,12]]},"references-count":14,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1111\/ctr.14804"],"URL":"https:\/\/doi.org\/10.1111\/ctr.14804","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,12]]},"assertion":[{"value":"2022-05-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14804"}}