title: The effect of donor-recipient gender mismatch on short- and long-term graft survival in kidney transplantation: a systematic review and meta-analysis.
abstract: BACKGROUND
  There is no limitation of gender matching in renal transplantation. This study was intended to evaluate its effect on short- and long-term graft survival.
  
  
  METHODS
  PubMed, the Web of Knowledge, Medline, the Cochrane Library, and two additional Chinese databases were searched. The data were then abstracted and meta-analyzed.
  
  
  RESULTS
  14 studies involving 445 279 patients were included. Each study reported data on the four gender matches (male donor-male recipient, MDMR; male donor-female recipient, MDFR; female donor-male recipient, FDMR; female donor-female recipient, FDFR). The pooled risk ratios (RRs) for 0.5-, 1-, 2-, 3-, 5-, and 10-yr graft survival rates showed that the FDMR group had the worst outcomes, and when recipients were female, short-term graft survival was worse, but long-term graft survival was better. The differences between groups changed with time.
  
  
  CONCLUSIONS
  FDMR patients showed poor graft survival. The female recipients had worse short-term graft survival but the best long-term graft survival. This study introduces an important consideration into donor-recipient matching in renal transplantation.
authors.affiliation: Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Jing-Yi
authors.initials: JY
authors.lastname: Zhou
authors.forename: Jun
authors.initials: J
authors.lastname: Cheng
authors.forename: Hong-Feng
authors.initials: HF
authors.lastname: Huang
authors.forename: Yi
authors.initials: Y
authors.lastname: Shen
authors.forename: Yan
authors.initials: Y
authors.lastname: Jiang
authors.forename: Jiang-Hua
authors.initials: JH
authors.lastname: Chen
mesh_terms: D005260:Female; D006085:Graft Survival / Q000502:physiology*; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D011183:Postoperative Complications; D012727:Sex Characteristics; D012737:Sex Factors; D015996:Survival Rate; D013997:Time Factors
keywords: donor; gender; graft survival; recipient; renal transplantation