The influence of donor gender on allograft vasculopathy: Evidence from intravascular ultrasound

Background. Allograft vasculopathy is a major risk factor for mortality following cardiac transplantation. Several immune and nonimmune factors have been evaluated as risk factors for the development of coronary vasculopathy. Objective. We evaluated the influence of donor gender on the progression of coronary vasculopathy in heart transplant recipients. Methods. Eighty-nine heart transplant recipients (67 men, 22 women of mean age: 56) 412 years) underwent serial volumetric intravascular ultrasound analysis (IVUS) at baseline (within I month) and at 1 year after transplantation. Patients were divided into four groups in relation to the donor-recipient gender status: female-female, n = 17; female-male, n = 28; male-female, n = 5; male-male, n = 39. Ultrasound images were recorded during an automated pullback and with an equal number of slices (average = 22 per coronary vessel). The measured IVUS indices for the left anterior descending artery were: change in maximal intimal thickness, average intimal area, total plaque volume, and intimal index. Results. Patients were similar in baseline characteristics. At 1 year after transplantation, IVUS indices of coronary vasculopathy were significantly increased among recipients, of female allografts (P < .05). Conclusion. Heart transplant recipients of female allografts display increased coronary vasculopathy progression.