Cornea donation may have sex bias

Sex matters when it comes to cornea transplants — at least for women.

Corneas are low on the list of organs that cause rejection, but it happens more often when women receive corneas from men, researchers report online July 22 in the American Journal of Transplantation. In data from nearly 17,000 transplants, 220 of every 1,000 male-to-female transplants failed versus 180 of every 1,000 sex-matched donations. For men, the donor’s sex didn’t matter.

The researchers suspect the problem is the H-Y antigen, found on the surface of most cells in a man’s body. The gene that encodes H-Y is on the Y chromosome, so women don’t have it. If their immune systems haven’t encountered the H-Y antigen before, women’s bodies may take it as a sign of a foreign invader and attack the transplant, says study coauthor Stephen Kaye, an ophthalmologist at the Royal Liverpool University Hospital in England. H-Y appears to be more of an issue in the cornea than in other organs.

If donated tissue is in short supply, however, women should take what’s available, Kaye says. It’s more important to get the cornea than to select who it came from.