title: Impact of donor-recipient gender on kidney graft and patient survival: short- and long-term outcomes.
abstract: OBJECTIVE
  Donor and recipient gender influence on post-transplant kidney and patient survival is still controversial, and the literature data do not present unanimous conclusions. The aim of this study was to evaluate the effect of gender disparities between donor and recipient in 963 kidney transplants performed at our center from January 2000 to December 2010.
  
  
  METHODS
  The patients were subdivided into four groups according to recipient and donor gender: male donor-to-male recipient (MDMR; n = 305), male donor-to-female recipient (MDFR; n = 203), female donor-to-female recipient (FDFR; n = 206), and female donor-to-male recipient (FDMR; n = 249). Independent sample's t test and one-way ANOVA were used for statistical analyses. Graft and patient survival were calculated by the Kaplan-Meier method and compared using the log rank test.
  
  
  RESULTS
  There were no statistically significant differences between the groups with regard to age, cold ischemia time, delayed graft function, primary non-function, and episodes of acute and chronic rejection. Moreover, no difference in either graft (p = 0.92) or patient (p = 0.41) survival at 1, 3, and 5 years was observed. However, female recipients had significantly lower serum creatinine values and higher estimated GFR, particularly if they received a male donor kidney, and these findings were stable up to 3-year post-transplantation.
  
  
  CONCLUSIONS
  No impact of gender on short- or long-term graft and patient survival was observed in deceased kidney transplantation. However, we report a lower creatinine level in the male donors to female recipients group as compared with other recipient-donor gender combinations, although this difference loses statistical significance after the third-year post-transplantation.
authors.affiliation: Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Piazza G. Cesare 11, 70124, Bari, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Vavallo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lucarelli
authors.forename: Marco
authors.initials: M
authors.lastname: Spilotros
authors.forename: Carlo
authors.initials: C
authors.lastname: Bettocchi
authors.forename: Silvano
authors.initials: S
authors.lastname: Palazzo
authors.forename: Francesco Paolo
authors.initials: FP
authors.lastname: Selvaggi
authors.forename: Michele
authors.initials: M
authors.lastname: Battaglia
authors.forename: Pasquale
authors.initials: P
authors.lastname: Ditonno
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology* / Q000517:prevention & control; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014019:Tissue Donors
chemical_list: D007166:Immunosuppressive Agents
references.citation: Pediatr Radiol. 1985;15(1):38-43
references.pmid: 3881724
references.citation: J Am Soc Nephrol. 2010 Jun;21(6):1022-9
references.pmid: 20488949
references.citation: Eye (Lond). 2000 Apr;14 ( Pt 2):201-5
references.pmid: 10845017
references.citation: Am J Transplant. 2011 Oct;11(10):2173-80
references.pmid: 21831156
references.citation: J Heart Lung Transplant. 2004 Nov;23(11):1252-9
references.pmid: 15539123
references.citation: J Am Soc Nephrol. 2002 Oct;13(10):2570-6
references.pmid: 12239247
references.citation: Clin Transplant. 2006 Mar-Apr;20(2):163-70
references.pmid: 16640522
references.citation: Am J Surg. 2011 Apr;201(4):463-7
references.pmid: 20864077
references.citation: Lancet. 2008 Jul 5;372(9632):49-53
references.pmid: 18603158
references.citation: Am J Kidney Dis. 1995 Apr;25(4):515-33
references.pmid: 7702046
references.citation: Transplant Proc. 2004 Sep;36(7):2040-2
references.pmid: 15518738
references.citation: J Biol Chem. 2004 Dec 10;279(50):52282-92
references.pmid: 15358759
references.citation: Transplant Proc. 2011 Jan-Feb;43(1):367-72
references.pmid: 21335224
references.citation: AJR Am J Roentgenol. 1993 Jan;160(1):83-6
references.pmid: 8416654
references.citation: Am J Kidney Dis. 1993 May;21(5 Suppl 2):66-72
references.pmid: 8494022
references.citation: Nephron. 2002 Feb;90(2):139-44
references.pmid: 11818696
references.citation: Transplant Proc. 2004 Sep;36(7):2015-7
references.pmid: 15518729
references.citation: AJR Am J Roentgenol. 1985 Sep;145(3):611-6
references.pmid: 3895872
references.citation: Transplant Proc. 1989 Feb;21(1 Pt 2):1554-5
references.pmid: 2652504
references.citation: Ann Hum Genet. 1962 May;25:379-85
references.pmid: 14454011
references.citation: Kidney Int. 2004 Apr;65(4):1252-61
references.pmid: 15086464
references.citation: Transpl Int. 2008 Apr;21(4):340-5
references.pmid: 18086285
references.citation: Clin Transplant. 1999 Apr;13(2):181-6
references.pmid: 10202615
references.citation: Transplantation. 1996 Dec 27;62(12):1784-7
references.pmid: 8990363
references.citation: Transplant Proc. 1992 Dec;24(6):2670-1
references.pmid: 1465895
references.citation: Clin Transpl. 1989;:361-7
references.pmid: 2487604
references.citation: J Am Soc Nephrol. 2000 Feb;11(2):319-329
references.pmid: 10665939