Sex Matching Plays a Role in Outcome of Kidney Transplant

Abstract

The effect of sex matching between donors and recipients was studied in 135 kidney transplant operations performed in our center between December 1998 and December 2007. Patients were divided into 4 groups: group 1 (63 patients, male donor-male recipient), group 2 (25 patients, male donor-female recipient), group 3 (37 patients, female donor-male recipient), and group 4 (10 patients, female donor-female recipient). Except for donor age, recipient body mass index and donor-recipient HLA AB-DR matching, recipient, and donor demographics, and the immunosuppression were comparable in all groups. Acute rejection and the need for antithymocyte globulin Fresenius rescue therapy were comparable between the 4 donor-recipient combinations. Excellent 1-year actuarial patient and graft survival, comparable hospital stay, and incidence of delayed graft and slow graft function were comparable between the 4 groups. One death occurred, each, in groups 1 and 2; posttransplant complications being comparable. While 1-year graft survival (death censored and uncensored) were comparable, 1-year graft function (serum creatinine) showed that the worst graft function was seen in group 3 (female-to-male). Significant differences between the 4 patient groups also were seen in pretransplant and posttransplant hemoglobin levels as well as in posttransplant arterial hypertension and high-density lipoprotein cholesterol blood levels. Other metabolic indices were generally comparable between the 4 patient groups. These results revealed that sex mismatching (group 2, male donor to female recipient) had the best 1-year graft function but the same 1-year patient and graft survival.