Background: Studies have yielded contradictory results on whether donor sex and donor-recipient sex disparity affect hepatocellular carcinoma (HCC) recurrence after living donor liver transplantation (LDLT). The present study assessed whether donor sex or donor-recipient sex disparity affects HCC recurrence after LDLT at a high-volume center.
Methods: This study included 772 HCC patients who underwent LDLT between January 2006 and December 2015 at Asan Medical Center. Patients were divided into four groups based on the sex of the donor and recipient: male-to-male (n=490 [63.5%]), male-to-female (n=75 [9.7%]), female-to-male (n=170 [22.0%]), and female-to-female (n=37 [4.8%]).
Results: Disease-free survival (DFS; P=0.372) and overall survival (OS; P=0.591) did not differ significantly among the four groups. DFS also did not differ significantly between LDLT recipients with male and female donors (P=0.792) or between male and female recipients (P=0.084). After patient matching with an alpha-fetoprotein/des-carboxy prothrombin/tumor volume score cutoff of 5 logs, donor-recipient sex disparity did not significantly affect DFS (P=0.598) or OS (P=0.777). There were also no differences in DFS in matched LDLT recipients with male and female donors (P=0.312) or between male and female recipients (P=0.374).
Conclusions: Neither donor sex nor donor-recipient sex disparity significantly affected posttransplant HCC recurrence.