Survival Outcomes of Kidney Transplantation Among Women of Reproductive Age in the United States [ID: 1373252

Abstract

INTRODUCTION: Adult kidney transplantation in the United States has steadily increased over the years. In 2018, there were 678 kidney recipients per million people, representing a 40% growth since 2008. Different studies have shown disparities in the rate and outcomes of kidney transplantation in the United States. However, few have explored how the social determinants of health influence the outcomes of kidney transplantation among women of reproductive age. This group needs to be studied separately as factors like sexuality, contraception, and pregnancy can complicate outcomes after transplantation. METHODS: We utilized data from the United Network for Organ Sharing (UNOS 1987–2022) database to explore outcomes of renal transplantation among women of the reproductive-aged group (15–49 years). The outcome measures include graft survival and overall patient survival. In addition, we compared outcomes among women and men across different age groups. In the multivariate analysis, we adjusted for the patient’s body mass index, donor’s age, sex, body mass index, preexisting comorbidities such as hypertension and diabetes, and ABO group. RESULTS: Among the 521,797 kidney transplant recipients in the United States kidney records in the study period, 282,253 were women. Among these female kidney recipients, 6,680 (3.2%) were aged less than 15 years, 101,908 (49.4%) were between 15 and 49 years, and the remaining 97,723 (47.4%) were above the age of 50 years. The 5- and 10-year survival according to age group was less than 15 years (78.5%, 60.4%), 15–49 years (74.7%, 55.5%), and 50 years or older (74.8%, 49.8%). Across the different age groups, outcomes were better in women than men. The table shows the influence of race and ethnicity, insurance type, and education level on graft and overall patient survival. CONCLUSION: Women kidney recipients have better outcomes compared to men. Increasing education level and race and ethnicity are significant drivers of outcomes among women renal transplant recipients in the reproductive-aged group.