Gender Bias in Kidney Donation in India: Has It Changed Over the Past 2 Decades?

Bhuwania, Sameer; Saxena, S.; Bansal, Ravi; Goel, Rajesh Kumar

doi:10.1016/j.transproceed.2019.12.056

Cited by 5 publications

(5 citation statements)

References 16 publications

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“…The current study included female patients who were underrepresented as transplant recipients and strongly overrepresented donors. This could be due to the predominance of donors in India being either mother or spouse 15 . Hence the results cannot be generalized to other transplant centers with a balanced sex distribution of recipients and donors.…”

Section: Discussionmentioning

confidence: 99%

Effect of Urinary tract infection on the outcome of the Allograft in patients with Renal transplantation

Gangula,

Eswarappa,

Reddy

et al. 2024

Preprint

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BackgroundUrinary Tract Infections (UTIs) are the second most common cause of graft dysfunction, accounting for significant morbidity, and are associated with poor graft and patient survival. This study aimed to determine the association between post-renal transplant UTI and graft outcomes.MethodsWe examined the effect of UTIs on graft outcomes in patients who underwent renal transplantation surgery between January 2010 and December 2022. The study population included 349 renal transplantations, of which 74 experienced 140 UTI events. Based on the number of UTI episodes, patients were categorized into three groupsResultsOf the 349 recipients, 275 (74.4%) had no UTI, 47 (18.8%) had nonrecurrent UTIs (NR-UTIs), and 27 (6.8%) had Recurrent UTIs (R-UTIs). NR-UTIs were associated with very poor graft survival compared with no UTI (Hazard Ratio [HR], 2.312; 95% Confidence Interval [CI], 1.410–3.791; P=0.001). This relationship persisted even after adjusting for confounding factors in Multivariable Cox regression analysis (HR, 2.318; 95% CI, 1.414–3.800; P=0.001). Although R-UTIs appeared to result in poor patient survival, the difference was not significant (vs No UTI, HR, 1.517; 95% CI, 0.983–2.342; P=0.060). There appeared to be higher patient survival in R-UTIs but was not significant (vs NR-UTI, HR, 1.316; 95% CI, 0.486–3.564; P=0.589). R-UTIs were more likely to be associated with Multi-drug Resistant Gram-negative organisms (Klebsiella pneumonia or Escherichia coli) with resistance to Nitrofurantoin (RR, 2.753; 95% CI, 1.257–6.032; P=0.01) and Carbapenem (RR, 2.064; 95% CI, 0.988–4.314; P=0.05).ConclusionNR-UTIs were associated with poorer graft and patient outcomes than no UTI.

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Section: Discussionmentioning

confidence: 99%

Effect of Urinary tract infection on the outcome of the Allograft in patients with Renal transplantation

Gangula,

Eswarappa,

Reddy

et al. 2024

Preprint

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“…In a study from India, donation rates were compared from 2001–2009 and 2010–2018. There were improvements in male donor rates from 26.05% to 38.58% and male recipient rates decreased from 81.51% to 78.7% mainly due to awareness programs in the country [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Providing “Free” Access to Dialysis and Transplant to the Disfranchised. A Sustainable Model for Low and Low Middle Income Countries (LMICs)

Zafar¹,

Rizvi²

2023

Transpl Int

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Pakistan is a low-middle income country where incidence of End Stage Kidney Disease (ESKD) is 100–150 per million population (pmp). Paucity and high costs of renal replacement therapy (RRT) renders the majority disfranchised, since the dialysis rate is 15 pmp and the transplant rate is 4–5 pmp. In view of this, our center started an integrated dialysis and transplant program where all treatment is provided “Free of Cost” to all patients, with lifelong follow-up and medications. The model is based on the concept of community-government partnership funded by both partners. The annual contribution in 2021 was $37.4 million. >1,500 patients were dialyzed daily, and 6–8 received transplants weekly. Of the 6,553 transplants performed between 1985–2021, 988 (15%) were children. Overall, the 1 and 5-year graft survival rate was 97% and 88%. The donor clinic has 3,786 donors in regular yearly follow-up for up to 30–35 years where ESKD prevalence is 0.29%. Access to dialysis was increased by establishing six satellite centers reducing patient time and travel costs. Cost reductions by dialyzer reuse and generic drugs resulted in an annual saving of $5.8 m. This sustainable model has overcome the inherent socio-economic, logistic, cultural, and gender biases in RRT in LMICs. It has provided RRT with equity to the disfranchised in Pakistan and can be replicated in other LMICs with community-government support.

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“…15 An Indian study showed the predominance of females as living donors, contributing over 70% in a single-center study with 557 living donors. 16 Studies from Iraq, Iran, and Saudi-Arabia have shown that most living donors and recipients were males. [17][18][19][20] Clearly, gender disparity in transplantation and donation in the context of living donation is multifactorial with biological, psychological, and economic factors affecting the gender gap.…”

Section: Discussionmentioning

confidence: 99%

Gender Disparity in Asian-Pacific Countries: An Analysis of the ASTREG-WIT-KT Registry

et al. 2022

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Gender Bias in Kidney Donation in India: Has It Changed Over the Past 2 Decades?

Cited by 5 publications

References 16 publications

Effect of Urinary tract infection on the outcome of the Allograft in patients with Renal transplantation

Effect of Urinary tract infection on the outcome of the Allograft in patients with Renal transplantation

Providing “Free” Access to Dialysis and Transplant to the Disfranchised. A Sustainable Model for Low and Low Middle Income Countries (LMICs)

Gender Disparity in Asian-Pacific Countries: An Analysis of the ASTREG-WIT-KT Registry

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