Abstract
Background and Aims: Recipient demographics affect outcomes after kidney transplantation. The aim of this study was to assess, for kidneys retrieved from living donors, the effect of recipient sex, ethnicity, and body mass index (BMI) on delayed graft function (DGF) and one-year graft function, incidence of acute rejection (AR), and recipient and graft survivals. Methods: A systematic review and meta-analysis was performed. EMBASE and MEDLINE databases were searched using algorithms through Ovid. Web of Science collection, BIOSIS, CABI, Korean Journal database, Russian Science Citation Index, and SciELO were searched through Web of Science. Cochrane database was also searched. Risk of bias was assessed using the NHBLI tools. Data analysis was performed using Revman 5.4. Mean difference (MD) and risk ratio (RR) were used in analysis. Results: A total of 5129 studies were identified; 24 studies met the inclusion criteria and were analysed. Female recipients were found to have a significantly lower serum creatinine 1-year-post renal transplantation (MD: −0.24 mg/dL 95%CI: −0.18 to −0.29 p < 0.01) compared to male recipients. No significant difference in survival between male and female recipients nor between Caucasians and Africans was observed (p = 0.08). However, Caucasian recipients had a higher 1-year graft survival compared to African recipients (95% CI 0.52−0.98) with also a lower incidence of DGF (RR = 0.63 p < 0.01) and AR (RR = 0.55 p < 0.01). Recipient obesity (BMI > 30) was found to have no effect on 1-year recipient (p = 0.28) and graft survival (p = 0.93) compared to non-obese recipients although non-obese recipients had a lower rate of DGF (RR = 0.65 p < 0.01) and AR (RR = 0.81 p < 0.01) compared to obese recipients. Conclusions: Gender mismatch between male recipients and female donors has negative impact on graft survival. African ethnicity and obesity do not to influence recipient and graft survival but negatively affect DGF and AR rates.
Highlights
In kidney transplantation, the relative contribution of donor versus other factors on clinical outcomes is considered a main criterion to allocate an organ [1].Living kidney donation (LKD) represents the optimal treatment for kidney failure [2,3]
The same findings were confirmed by Jacobs et al [11], who reported no difference between graft survival in male recipients who had received their kidney from a male or female donor at one year post-transplantation; at three years of follow up, male recipients who had received a transplant from a male donor were 65% less likely to lose a graft compared to male recipients who received graft from a female donor (RR = 0.35; chi-square p = 0.006)
A major challenge is to optimize modifiable variables that could improve long-term survival [34], and with the present study, we aimed to assess the impact of recipient demographic characteristics of sex, ethnicity, and body mass index (BMI) on kidney grafts retrieved from living donor (LD)
Summary
The relative contribution of donor versus other factors on clinical outcomes is considered a main criterion to allocate an organ [1].Living kidney donation (LKD) represents the optimal treatment for kidney failure [2,3]. Previous reports on deceased donation indicate that the donor constitution has small or moderate effect on post-transplant clinical outcomes [4], while it is widely accepted that a living donor (LD) kidney tends to function immediately, reducing the risk of hospitalisation and renal replacement therapy after transplantation to less than 4% [5] and setting up the recipient for the best possible result. The aim of this study was to assess, for kidneys retrieved from living donors, the effect of recipient sex, ethnicity, and body mass index (BMI) on delayed graft function (DGF) and one-year graft function, incidence of acute rejection (AR), and recipient and graft survivals. Caucasian recipients had a higher 1-year graft survival compared to African recipients (95% CI 0.52−0.98) with a lower incidence of DGF (RR = 0.63 p < 0.01) and AR (RR = 0.55 p < 0.01). African ethnicity and obesity do not to influence recipient and graft survival but negatively affect DGF and AR rates
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
