Kidney Transplantation and “Sex Mismatch”: A 10-Year Single-Center Analysis

Graňák, Karol; Kováčiková, Lea; Skálová, Petra; Vnučák, Matej; Miklušica, Juraj; Laca, Ľ; Mokáň, Marián; Dedinská, Ivana

doi:10.12659/aot.921117

Cited by 7 publications

(9 citation statements)

References 25 publications

(36 reference statements)

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“…There is conflicting literature examining the impact of donor-recipient sex MM on graft outcomes. Although many studies have suggested an increased risk of graft failure in female recipients of male donor kidneys, [12][13][14] other studies have failed to show this effect. 20,21,27 This may relate to the fact that the protective effect observed when smaller female recipients receive organs from male donors with a larger kidney mass has not always been taken into account 22,28,29 and may offset the detrimental HY antigen effect.…”

Section: Discussionmentioning

confidence: 99%

“…Earlier studies have demonstrated a higher risk of graft loss in female recipients transplanted with male donor organs. [12][13][14][15]…”

mentioning

confidence: 99%

“…[8][9][10][11] Despite this, the potential impact of non-HLA antibodies on posttransplant outcomes is rarely, if ever, considered.Earlier studies have demonstrated a higher risk of graft loss in female recipients transplanted with male donor organs. [12][13][14][15]…”

mentioning

confidence: 99%

“…Earlier studies have demonstrated a higher risk of graft loss in female recipients transplanted with male donor organs. 12-15 This increased risk remains even when known confounders, such as recipient native kidney disease, donor and recipient age, HLA MM, and preformed panel-reactive antibodies (PRAs), are considered. 12 The presumed mechanism relates to HY minor histocompatibility antigens that are found on the Y chromosome.…”

mentioning

confidence: 99%

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The Role of Donor Sex in Females Undergoing Repeat Kidney Transplant: Does Prior Donor Sex Matter?

Craig

Tennankore

Kiberd

et al. 2022

Transplantation Direct

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F or individuals living with end-stage kidney disease (ESKD), kidney transplantation is the best treatment option for eligible patients, offering significant improvement in survival as well as quality of life versus remaining on dialysis. 1,2 Graft loss after kidney transplantation has devastating consequences, leading to increased morbidity, mortality, and reduced quality of life. 3 Donor-specific antibodies against HLAs have been shown to have adverse effects on transplant survival because of a well-established risk of antibody-mediated transplant rejection. 4 Routine pretransplant screening for donor-specific anti-HLA antibodies has led to improved kidney transplant outcomes over time 5 by informing the assignment of donor organs to recipients who lack HLA-incompatible antibodies or by identifying recipients who would benefit from desensitization protocols. 6 Given the known role of HLA mismatch (MM) in kidney transplant outcomes, many deceased donor kidney allocation protocols optimize HLA match between donors and recipients, with organs preferentially allocated to patients with a 0 HLA MM. 7 However, there is evidence to suggest that non-HLA minor histocompatibility antigens may also play an important role in transplant rejection. [8][9][10][11] Despite this, the potential impact of non-HLA antibodies on posttransplant outcomes is rarely, if ever, considered.Earlier studies have demonstrated a higher risk of graft loss in female recipients transplanted with male donor organs. [12][13][14][15]

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Section: Discussionmentioning

confidence: 99%

“…Earlier studies have demonstrated a higher risk of graft loss in female recipients transplanted with male donor organs. [12][13][14][15]…”

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

The Role of Donor Sex in Females Undergoing Repeat Kidney Transplant: Does Prior Donor Sex Matter?

Craig

Tennankore

Kiberd

et al. 2022

Transplantation Direct

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show abstract

“…To this regard, as a risk factor for inferior outcomes in women, it is worth to mention the theory related to the sex-determined minor histocompatibility antigen (H-Y antigen), firstly described in 1976 on a female recipient who rejected the bone marrow transplant from her HLA-identical brother [ 37 ]. More recently, the highest number of H-Y antibodies detected in the blood of female recipients transplanted with kidneys from male donors in comparison to other sex combinations was reported to significantly correlate with the higher occurrence of acute rejection [ 38 ]. This consideration implies a careful evaluation of every possible intervention and consequent risk of sensitization in transplant patients [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Recipient Demographics on Outcomes from Living Donor Kidneys: Systematic Review and Meta-Analysis

Bellini

Nozdrin

Pengel

et al. 2021

JCM

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Background and Aims: Recipient demographics affect outcomes after kidney transplantation. The aim of this study was to assess, for kidneys retrieved from living donors, the effect of recipient sex, ethnicity, and body mass index (BMI) on delayed graft function (DGF) and one-year graft function, incidence of acute rejection (AR), and recipient and graft survivals. Methods: A systematic review and meta-analysis was performed. EMBASE and MEDLINE databases were searched using algorithms through Ovid. Web of Science collection, BIOSIS, CABI, Korean Journal database, Russian Science Citation Index, and SciELO were searched through Web of Science. Cochrane database was also searched. Risk of bias was assessed using the NHBLI tools. Data analysis was performed using Revman 5.4. Mean difference (MD) and risk ratio (RR) were used in analysis. Results: A total of 5129 studies were identified; 24 studies met the inclusion criteria and were analysed. Female recipients were found to have a significantly lower serum creatinine 1-year-post renal transplantation (MD: −0.24 mg/dL 95%CI: −0.18 to −0.29 p < 0.01) compared to male recipients. No significant difference in survival between male and female recipients nor between Caucasians and Africans was observed (p = 0.08). However, Caucasian recipients had a higher 1-year graft survival compared to African recipients (95% CI 0.52−0.98) with also a lower incidence of DGF (RR = 0.63 p < 0.01) and AR (RR = 0.55 p < 0.01). Recipient obesity (BMI > 30) was found to have no effect on 1-year recipient (p = 0.28) and graft survival (p = 0.93) compared to non-obese recipients although non-obese recipients had a lower rate of DGF (RR = 0.65 p < 0.01) and AR (RR = 0.81 p < 0.01) compared to obese recipients. Conclusions: Gender mismatch between male recipients and female donors has negative impact on graft survival. African ethnicity and obesity do not to influence recipient and graft survival but negatively affect DGF and AR rates.

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Effects of biological sex mismatch on neural progenitor cell transplantation for spinal cord injury in mice

et al. 2022

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Despite advancement of neural progenitor cell transplantation to spinal cord injury clinical trials, there remains a lack of understanding of how biological sex of transplanted cells influences outcomes after transplantation. To address this, we transplanted GFP-expressing sex-matched, sex-mismatched, or mixed donor cells into sites of spinal cord injury in adult male and female mice. Biological sex of the donor cells does not influence graft neuron density, glial differentiation, formation of the reactive glial cell border, or graft axon outgrowth. However, male grafts in female hosts feature extensive hypervascularization accompanied by increased vascular diameter and perivascular cell density. We show greater T-cell infiltration within male-to-female grafts than other graft types. Together, these findings indicate a biological sex-specific immune response of female mice to male donor cells. Our work suggests that biological sex should be considered in the design of future clinical trials for cell transplantation in human injury.

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Kidney Transplantation and “Sex Mismatch”: A 10-Year Single-Center Analysis

Cited by 7 publications

References 25 publications

The Role of Donor Sex in Females Undergoing Repeat Kidney Transplant: Does Prior Donor Sex Matter?

The Role of Donor Sex in Females Undergoing Repeat Kidney Transplant: Does Prior Donor Sex Matter?

The Impact of Recipient Demographics on Outcomes from Living Donor Kidneys: Systematic Review and Meta-Analysis

Effects of biological sex mismatch on neural progenitor cell transplantation for spinal cord injury in mice

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