Gender imbalance in living donor renal transplantation.
BACKGROUND
Previous studies have shown more women than men among living donors (LD) and more men among recipients of those kidneys. In this study, we compared the evolving demographics of LD transplants.


METHODS
We retrospectively analyzed all LD transplants performed in our center between 1964 and 2000.


RESULTS
Among 1182 LD cases, 1035 (88%) were biologically related (LRD) and 147 (12%) were unrelated (LURD). LURD donors and recipients were significantly older than LRD donors and recipients, respectively (P=0.0001). More LURD allograft recipients were male (71%) compared with LRD recipients (57%) (P=0.0013). The proportion of female donors was 55% in both groups. Spousal donations were predominantly wife-to-husband (69%). Compared with the LRD group, there was a greater proportion of female-to-male LURD transplants (46 vs. 30%) and a smaller proportion of female-to-female LURD transplants (10 vs. 25%) (P=0.0001). When spousal pairs were excluded from the analysis, there was a higher proportion of male-to-male (48 vs. 27%) donations and a lower proportion of male-to-female (18 vs. 9%) and female-to-female (25 vs. 17%) transplants in the LURD group (P=0.001).


CONCLUSIONS
Gender disparities in LD transplantation are primarily due to a higher proportion of wife-to-husband donations and a lower incidence of male-to-female grafts among nonspousal LURD transplants. Strategies should be devised to ensure access for women to renal transplantation and to encourage and facilitate donation by men.
Kayler
Liise K
LK
Department of Surgery, University of Michigan Health System, Ann Arbor, MI 48109, USA.
Meier-Kriesche
Herwig-Ulf
HU
Punch
Jeffrey D
JD
Campbell
Darrell A
DA
Leichtman
Alan B
AB
Magee
John C
JC
Rudich
Steven M
SM
Arenas
Juan D
JD
Merion
Robert M
RM
D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D012189:Retrospective Studies; D012737:Sex Factors; D014019:Tissue Donors