The Survival Rate of Living-Donor Liver Transplantation Between Same-Sex and Opposite-Sex Recipients

<b>Purpose</b>: Living-donor liver transplantation (LDLT) serves as a solution for patients facing end-stage liver disease. The existing literature indicates that sex differences between transplant donors and recipients might influence survival rates. <b>Methods</b>: We used a retrospective study design to investigate the impact of different sex pairings on the survival rates of adult LDLT recipients. This study involved the long-term tracking of recipients who underwent LDLT between 7 June 2000 and 31 December 2021. <b>Results</b>: In total, 169 pairs (37.1%) of male recipients with male donors, 145 pairs (31.8%) of male recipients with female donors, 77 pairs (16.9%) of female recipients with female donors, and 65 pairs (14.3%) of female recipients with male donors were submitted for analysis. With independent <i>t</i>-tests or chi-squared tests demonstrating that liver weight and graft-to-recipient weight ratio (GRWR) for same-sex LDLT recipients were significantly higher than opposite-sex recipients; significant differences in disease diagnoses between same-sex and opposite-sex LDLT recipients were found. The Kaplan-Meier survival curve indicates that while same-sex pair survival rates were higher than opposite-sex pairs, the difference was not statistically significant. <b>Conclusions</b>: While sex matching might have some impact on survival rates, it is influenced by a variety of factors, so the effects of donor and recipient sex matching on liver transplantation remains controversial. The findings of this study can serve as a reference for living-donor liver transplant teams when making donor selection decisions.