2025 ISAKOS Biennial Congress Paper
Deleterious Effect of Sex Mismatch Between Donor and Recipient After Meniscus Allograft Transplantation (MAT): An Analysis of the Impact of Donor and Patients Demographics on a Series of 360 MAT
Gian Andrea Lucidi, MD, Bologna ITALY
Stefano Di Paolo, Eng, PhD, Bologna ITALY
Giovanni Balboni, MD, Ferrara ITALY
Leonardo Vivarelli, ENG, Bologna ITALY
Marco Govoni, PhD, Bologna ITALY
Lucia de Franceschi, MD, Bologna ITALY
Iacopo Romandini, MD, Doha QATAR
Giuseppe Filardo, MD, PhD, MBA, Prof., Lugano SWITZERLAND
Alberto Grassi, PhD, Bologna ITALY
Dante Dallari, MD, Bologna ITALY
Stefano Zaffagnini, MD, Prof., Bologna ITALY
Istituto Ortopedico Rizzoli, Bologna, ITALY
FDA Status Cleared
Summary
Meniscal allograft transplant (MAT) survival is significantly lower in case of sex mismatch, while donor age, BMI, and graft freezing time have no significant impact on outcomes.
Abstract
Objective
The use of meniscal allograft transplant (MAT) is increasing over time but the allograft availability is limited due to strict inclusion criteria for donation and patients matching. Moreover, in literature no studies have investigated the impact of allograft conservation time, demographic characteristics of the donor and the combination of donor and patients factors on the outcomes of MAT.
Purpose
To investigate the effect of graft freezing-time, demographical characteristics of the donor (age, sex, body mass index (BMI)) and the effect of mismatch of those demographical parameters between donor and patients on the survivorship of MAT.
Methods
375 consecutive MAT procedures were performed in a single institution with soft tissue fixation technique between 2004 and 2021 and were screened and assessed for eligibility. Patients were included in the study in the presence of complete demographic data for both the donor and recipient and minimum 2 years of follow-up. Failure was defined as the need for graft removal for any reason (including infection, graft tear, total knee arthroplasty). Statistical analysis was performed via the Kaplan-Meier method to compare the graft survivorship based on the sex mismatch between the patients and the donor groups. A Receiver Operating Curve (ROC) was performed to evaluate the association of age, sex, BMI of the donor and difference between those parameters between the donor and the patients (age,sex,BMI) with MAT failure.
Results
A total of 360 patients at a mean 8.8±3.6 years were included in the present study. Female patients who received a MAT from a male donor had a failure rate of 38.89%, which was significantly higher when compared with the other groups. The failure rate in the male-to-male group was 7.26%, while in the female-to-female group was 9.19%. . Hazard ratios with 95% confidence interval was calculated as 9.7 (1.3-71.1) in relation to group female-male in comparison with group male-male.
The analysis performed on graft freezing time, age, sex and BMI of the donor as well as difference in age or BMI of the donor and patients did not find any association of those parameters with failure.
Conclusion
Mismatch between donor and recipient sex had a negative effect on MAT survival only when a meniscus from a male donor was transplanted in a female patient. While age and BMI of the patients does not seem to affect the outcomes, the decision to transplant meniscus from a male donor should be carefully considered based on the results of the present study.