Gender plays a role in transplant success


X and Y chromosomes may influence heart and kidney rejection. Andrew Masterson reports.


A human heart: the gender of the donor and recipient may be important.
A human heart: the gender of the donor and recipient may be important.
Kristine Lindsey / EyeEm / Getty Images

Different hormones produced by men and women may influence the success of organ transplants, a new report finds.

A paper published in the journal Trends in Immunology represents the first time the influence of gender in organ donors and recipients has been assessed. The study, led by surgeon Stefan Tullius from the Brigham and Women’s Hospital in Boston, US, found that some kinds of female donor organs are more likely to be rejected.

The researchers found that in kidney transplants, female organs were more often rejected than male ones – a trend higher among male recipients. In heart transplants, too, female organs were more often rejected, but in this case only in male recipients.

And while the gender bias in transplant rejection was by no means universal, it is considered significant.

“In solid organ transplantation, the importance and implications of the sex of both the donor and the recipient have long been underappreciated,” says Tullius.

“The differences may be subtle but I think they are very relevant, particularly as we move toward individualising immunosuppression and try to find ways to be more specific in our treatment. I think understanding the relevance of sex differences will play a significant role in this.”

The mechanisms influencing gender-determined transplant failure are still being examined, but Tullius and colleagues suggest sex chromosomes may be a factor.

They note that X-chromosomes contain about 50 genes linked to immunological functions, and that these tend to be expressed more variably in women than in men. The Y-chromosome, found only men, contains locations that bond with male-only toxins, or antigens.

These factors may influence immune cell functions after transplants. The researchers suggest therapies that target hormone receptors might in future reduce the rate of gender-influence transplant failure.

  1. http://www.cell.com/trends/immunology/fulltext/S1471-4906(18)30019-X
  2. http://www.cell.com/trends/immunology/fulltext/S1471-4906(18)30019-X
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