Purpose: In different allo-organ transplantations such as heart and kidney transplantation, feminine donor organs are associated with a significant decreased long-term survival outcome. The aim of our study was to determine if gender mismatches influence survival outcomes.
Methods: In this retrospective, single center study of 375 adult lung transplant recipients (median follow-up of 1417 days), we analyzed long-term survival and the effect of gender mismatches between recipient and donor (Kaplan-Meier, multivariate regression).
Results: More females (51.5%) were transplanted (median age 50 years; range 16-65) compared to men (median age 51 years; range 17-65; p=n.s.). Matched gender transplants showed a better long term survival outcome compared to mismatched gender transplants in our 16 years of follow up (43% vs 31%, p=0.006).A gender mismatched female donor transplanted into a male showed a 5 year survival of 56%, whereas a gender matched transplant showed a 5 year survival of 75% (female-female) respectively 70% (male-male) (p=0.006). A male donor transplanted into a female showed a high peri-operative mortality that eventually led to a 5-year survival of 43%. Eurotransplant data will be incorporated and available in March 2018.

Conclusion: The significant worse long-term survival outcome of female donors in gender mismatched lung transplant recipients and the extremely high peri-operative mortality in gender mismatched male donors needs further elucidation.