Gender Differences in Mortality of Candidates for Heart Transplantation in Israel

Background: Few previous studies have concluded that females have a higher mortality rate than males while waiting for heart transplantation. The aim of this research is to investigate whether gender differences in wait-list mortality also exists in Israel.

Methods: Based on data from the National Transplant Center, we included all 295 patients who were listed for heart transplantation in Israel between January 2008 and October 2014, of which 73 (24%) were females. Endpoints were death while on the list, alive and waiting, underwent heart transplantation or delisting due to clinical deterioration or improvement.

Results: There were 139 Status 1 candidates (30% females) and 156 Status 2 candidates (19% females). The patients were diagnosed with ischemic cardiomyopathy (7 females, 124 males) and non- ischemic cardiomyopathy (66 females, 98 males). There was no statistical difference in the overall mortality rates on the waiting list between males and females (33% males, 22% females, overall mortality- 30% [89]; P=0.08). Similarly, there was no statistical difference in mortality between the genders among the subgroups of diagnosis (34% ischemic cardiomyopathy [29% females]; p=0.1, 27% non-ischemic cardiomyopathy [21% females]; p= 0.157). While there was no difference in mortality between males and females among Status 1 candidates (28% in males and 26% in females; p=0.839), mortality among status 2 male candidates was significantly higher than that among female candidates (32% in males and 16% in females; p=0.05).

Conclusion: Mortality of candidates for heart transplantation in Israel, while similar to that commonly observed in most Western countries, is not gender dependent among Status 1 patients, and is significantly lower among females Status 2 candidates.