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Peer-reviewedCC BY 4.0Transplant International

Differences in excess mortality by recipient sex after liver transplant

  • Lauren Tal Grinspan1
  • Xun Zhang2
  • Mourad Dahhou2
  • Caner Süsal3,4,5
  • Doehler Bernd3
  • Anette Melk6
  • Amanda Vinson7
  • Bethany J. Foster2,8,9
9 affiliations
  1. 1Recanati/Miller Transplantation Institute, Mount Sinai Hospital, New York, NY, United States
  2. 2Research Institute of the McGill University Health Centre, Montreal, QC, Canada
  3. 3UniversitatsKlinikum Heidelberg Institut fur Immunologie, Heidelberg, Germany
  4. 4Transplant Immunology Research Center of Excellence, Koc Universitesi, İstanbul, Türkiye
  5. 5Koc Universitesi Tip Fakultesi, İstanbul, Türkiye
  6. 6Medizinische Hochschule Hannover, Hanover, Germany
  7. 7Department of Medicine, Nephrology Division, Dalhousie University, Halifax, NS, Canada
  8. 8McGill University Department of Epidemiology Biostatistics and Occupational Health, Montreal, QC, Canada
  9. 9Division of Nephrology, Mcgill University Department of Pediatrics, Montreal, QC, Canada
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Abstract

Identification of sex differences in mortality may prompt sex-specific management strategies. Males worldwide have higher mortality than females; therefore, we compared sex differences in excess mortality. We compared excess mortality in female versus male first liver transplant recipients, accounting for modifying effects of donor sex and recipient current age using relative survival models. Models were fitted separately in Scientific Registry of Transplant Recipients and CTS cohorts (1988–2019) and subsequently combined using two-stage individual patient data meta-analysis. We analyzed 218,429 patients. Within the first 3 months post-transplant, female recipients ≥25 years showed significantly higher excess mortality regardless of donor sex and female recipients 13–24 years had significantly higher excess mortality when the donor was male. Subsequent to the first 3 months, female recipients 0–12 years had significantly lower excess mortality regardless of donor sex; female recipients ≥25 years had lower excess mortality, though only significantly among those 25–44 years with a female donor. Females ≥25 years showed higher excess mortality than males in the immediate post-transplant period but, among those who survived, the first 3 months, excess mortality was similar by sex or lower in females than males. After the first 3 months post-transplant, female recipients 0–12 years showed lower excess mortality.

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Cite

BibTeXRIS
BibTeX
@article{grinspan2026differences,
  title = {{Differences in excess mortality by recipient sex after liver transplant}},
  author = {Lauren Tal Grinspan and Xun Zhang and Mourad Dahhou and Caner Süsal and Doehler Bernd and Anette Melk and Amanda Vinson and Bethany J. Foster},
  journal = {Transplant International},
  year = {2026},
  month = oct,
  doi = {10.3389/ti.2026.16922},
  url = {https://doi.org/10.3389/ti.2026.16922},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Differences in excess mortality by recipient sex after liver transplant
AU  - Lauren Tal Grinspan
AU  - Xun Zhang
AU  - Mourad Dahhou
AU  - Caner Süsal
AU  - Doehler Bernd
AU  - Anette Melk
AU  - Amanda Vinson
AU  - Bethany J. Foster
PY  - 2026
DA  - 2026/10/12
JO  - Transplant International
DO  - 10.3389/ti.2026.16922
UR  - https://doi.org/10.3389/ti.2026.16922
AB  - Identification of sex differences in mortality may prompt sex-specific management strategies. Males worldwide have higher mortality than females; therefore, we compared sex differences in excess mortality. We compared excess mortality in female versus male first liver transplant recipients, accounting for modifying effects of donor sex and recipient current age using relative survival models. Models were fitted separately in Scientific Registry of Transplant Recipients and CTS cohorts (1988–2019) and subsequently combined using two-stage individual patient data meta-analysis. We analyzed 218,429 patients. Within the first 3 months post-transplant, female recipients ≥25 years showed significantly higher excess mortality regardless of donor sex and female recipients 13–24 years had significantly higher excess mortality when the donor was male. Subsequent to the first 3 months, female recipients 0–12 years had significantly lower excess mortality regardless of donor sex; female recipients ≥25 years had lower excess mortality, though only significantly among those 25–44 years with a female donor. Females ≥25 years showed higher excess mortality than males in the immediate post-transplant period but, among those who survived, the first 3 months, excess mortality was similar by sex or lower in females than males. After the first 3 months post-transplant, female recipients 0–12 years showed lower excess mortality.
SN  - 0934-0874
SN  - 1432-2277
ER  -