Heart failure & cardiomyopathiesCohort study
Sex Differences in Heart Transplantation Outcomes
- Multivariable Fine-Gray competing risk analyses and multivariable Cox regression of United Network for Organ Sharing Registry data
- waitlist cohort
- transplant cohort
- October 18, 2018, and October 17, 2023
Authors' conclusion
Five years after implementation of the 2018 allocation policy, women have higher rates of HT and lower delisting due to death or clinical deterioration as compared to men with lower long-term post-HT survival.
Study context
- Population
- Adults (≥18 years) listed for first-time, single-organ heart transplant (HT) in the United Network for Organ Sharing Registry, and first-time single-organ HT recipients, after the 2018 U.S. allocation policy revisionwaitlist candidates (26.3% women) 15,422 · HT recipients (27.4% women) 12,892
- Exposure
- Women vs men
Main finding
Rate of HT (waitlist cohort)
Adjusted subdistribution HR (aSHR)
1.24
95% CI 1.18–1.31
P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| Adjusted post-HT mortality · 1-year · higher in women | 1.14 (1.02–1.28) | P = 0.019 | |
| Adjusted post-HT mortality · 5-years · higher in women | 1.14 (1.02–1.27) | P = 0.021 | |
| 0.512Adjusted hazard ratio (log scale) |
| Outcome | aSHR (95% CI) | P value |
|---|---|---|
| Delisting for death or clinical deterioration (waitlist cohort) · lower rate in women | 0.81 (0.70–0.94) | P = 0.005 |
Original publication
Sex Differences in Heart Transplantation Outcomes. JACC Adv. Published 20 May 2026. doi:10.1016/j.jacadv.2026.102820
Summarised from the published abstract; every number is checked against it