#1866 Gender gap in renal transplantation, myth or truth?

Abstract

Abstract Background and Aims Multiple works show that women are less likely to receive a kidney transplant (Tx) compared to their male counterparts. We aimed to study the sex differences in access to Tx in our waiting list. We also studied the rate of masculine and feminine donors (Do) and their match to same-sex recipients (Rc). Method We included all adult patients active in our transplant waiting list during a 2-year period (from January 1-2021 to December 31-2022). Our center is a medium volume transplant center, and we only perform Tx from deceased donors, and don't perform combined organ transplantation. We analyzed the rate of women vs male, and Rc's and Do's sex, the degree of sex match and mismatch. We evaluated differences in time in waiting list until Tx, re-transplantation, and hyperimmunized patients, between groups. Results 270 individuals were active in our waiting list, 174 (64%) men, and 96 (36%) women. 142 were transplanted during the study period, 92 (65%) were males, and 50 (35%) females. We found no differences in terms of age, BMI, time to Tx, condition of hyperimmunized or re-Tx in the Rc's group and the rate of Tx (p = 0.34) (see Table A). We had 102 donors, ♀ 41 (40%), ♂ 61 (60%), regarding to their features, differences between age and BMI were statistically non-significant, neither in individually nor delta analysis (see Tables B-C, and Figs A-B). Proportionally more male kidneys were transplanted to female Rc's. Conclusion In our sample, we had a 2:1 rate of males to women in our waiting list, and in access to Tx. Relatively more women received a kidney form a male Do (46 vs 31%). Although other studies find a gender gap in access to kidney Tx, this phenomenon was not found in our sample. However, our results may be conditioned by a small sample size. We need to design well powered and multicentric studies, to dilucidate this controversial issue.