Conclusions
In this analysis of patients undergoing primary OHT, we found FtoM
recipients to have the lowest unadjusted one-year posttransplant
survival, and both FtoF and FtoM donation to be associated with
increased hazards of mortality after risk adjustment. When looking at
proportions of undersizing in these donor-to-recipient sex matching
cohorts, FtoM had the lowest rates of undersizing using weight and BMI
sizing metrics. However, when looking at distributions of sizing using
the pHM metric, FtoM recipients were actually most frequently
undersized, accounting for nearly half of the population. In this
cohort, increasing degree of undersizing is associated with increased
hazards of mortality using all sizing metrics. However, in large degrees
of undersizing, pHM had the largest associations with increased
mortality. It appears that donor-to-recipient sizing using weight and
BMI may be misleading in this FtoM cohort, and pHM may be the best
sizing metric to use for these higher-risk patient subset.