H-Y incompatibility predicts short-term outcomes for kidney transplant recipients.
A recent report suggested that female recipients of male deceased-donor kidneys are at increased risk for graft failure because of H-Y antigen mismatch. In an attempt to confirm and extend these results, we studied all adult recipients of deceased-donor kidney transplants from 1990 through 2004 in the US Renal Data System. Compared with all other gender combinations, female recipients of male donor kidneys had a 12% increased risk for graft failure at 1 yr (hazard ratio 1.12; 95% confidence interval 1.05 to 1.19) but no excess risk at 10 yr (hazard ratio 1.03; 95% confidence interval 0.98 to 1.07). We observed a similar pattern of short- and long-term risk for both death-censored graft failure and mortality. The main results were consistent across several prespecified patient subgroups and were robust to sensitivity analyses. In conclusion, compared with other recipient-donor gender combinations, female recipients of male donor kidney transplants in the United States have an increased short-term risk but not long-term risk for adverse outcomes.
Kim
S Joseph
SJ
Division of Nephrology, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada. joseph.kim@uhn.on.ca
Gill
John S
JS
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology* / Q000401:mortality*; D006182:H-Y Antigen / Q000276:immunology*; D006648:Histocompatibility / Q000276:immunology; D006801:Humans; D007518:Isoantibodies / Q000276:immunology; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000276:immunology* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D017678:Sex Distribution; D014019:Tissue Donors / Q000706:statistics & numerical data; D055815:Young Adult
D006182:H-Y Antigen; C051256:H-Y antibody; D007518:Isoantibodies