Experience in donor-recipient gender mismatching heart transplantation: analysis of seven female patients receiving male donor hearts

Objective To summarize the experience in donor-recipient gender mismatching heart transplantation. Methods Seven female patients with end-stage cardiopathy aged 13~44, underwent orthotopic transplantation of hearts from male donors. Fine-tuning immunosuppressive protocols were adopted: Stanford classic therapy was applied on 3 cases and immunosupression induction therapy was applied on 4 cases. The clinical outcomes were observed for an average of 20 months (5~54 months). Results No acute reject reaction was found in all 7 cases within 3 months postoperatively. The earliest 2 patients died of refractory rejection 38 and 34 months postoperatively due to immunosuppressive withdrawal because of financial difficulty. The other 5 cases resumed their normal work and daily life. No allograft dysfunction, severe opportunistic infection episodes, and injury of liver and kidney functions were found in all cases. Conclusion Fine-tuning immunosuppressive protocols improve the short-term and long-term clinical effects of donor-recipient gender mismatching heart transplantation.