Gender in the allocation of organs in kidney transplants: meta-analysis

Abstract

OBJECTIVE To analyze whether gender influence survival results of kidney transplant grafts and patients.METHODS Systematic review with meta-analysis of cohort studies available on Medline (PubMed), LILACS, CENTRAL, and Embase databases, including manual searching and in the grey literature. The selection of studies and the collection of data were conducted twice by independent reviewers, and disagreements were settled by a third reviewer. Graft and patient survival rates were evaluated as effectiveness measurements. Meta-analysis was conducted with the Review Manager® 5.2 software, through the application of a random effects model. Recipient, donor, and donor-recipient gender comparisons were evaluated.RESULTS : Twenty-nine studies involving 765,753 patients were included. Regarding graft survival, those from male donors were observed to have longer survival rates as compared to the ones from female donors, only regarding a 10-year follow-up period. Comparison between recipient genders was not found to have significant differences on any evaluated follow-up periods. In the evaluation between donor-recipient genders, male donor-male recipient transplants were favored in a statistically significant way. No statistically significant differences were observed in regards to patient survival for gender comparisons in all follow-up periods evaluated.CONCLUSIONS The quantitative analysis of the studies suggests that donor or recipient genders, when evaluated isolatedly, do not influence patient or graft survival rates. However, the combination between donor-recipient genders may be a determining factor for graft survival.

Sex Differences in Renal Function: Participation of Gonadal Hormones and Prolactin

“…This result has been observed in many subsequent studies [61][62][63]. It is considered that kidney allograft survival is better in a maledonor to a male-recipient [64,65]. Many factors could be involved in these sex differences.…”

Association of Sex with Risk of Kidney Graft Failure Differs by Age

“…6,20 Male-donor kidneys are believed to offer superior graft survival due to a greater nephron mass than female-donor kidneys. 22,23,[38][39][40][41] Indeed, prior studies concluded that male recipients of female-donor kidneys have poorer graft survival than all other recipient-donor sex combinations. [38][39][40][41] We do not dispute the validity of this conclusion in populations dominated by recipients .45 years old.…”

Ten-year kidney transplant survival of cyclosporine- or tacrolimus-treated patients in Brazil

“…Gender did not influence graft survival in our study. However recent studies have suggested men have a higher risk of graft loss compared with women in the long term (11,(36)(37)(38) .…”