Donor-recipient Sex Differences Do Not Affect Survival Outcomes After Kidney Transplantation: A Population Cohort Study

Morgan, Georgia; Goolam‐Mahomed, Zahrah; Hodson, James; Nath, Jay; Sharif, Adnan

doi:10.1097/tp.0000000000002915

Cited by 14 publications

(15 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We believe that our data do not allow a definitive conclusion about the influence of the sex of the recipient on patient survival. On the other hand, we did not find any indication for an impact of donor-recipient sex mismatch on transplant outcomes, corroborating the results of other studies (21,22).…”

Section: Discussionsupporting

confidence: 92%

Impact of Combinations of Donor and Recipient Ages and Other Factors on Kidney Graft Outcomes

et al. 2020

View full text Add to dashboard Cite

As the availability of kidneys for transplantation continues to be outpaced by its growing demand, there has been an increasing utilization of older deceased donors in the last decades. Considering that definition of factors that influence deceased donor kidney transplant outcomes is important for allocation policies, as well as for individualization of post-transplant care, the purpose of this study was determine the risks for death censored graft survival and for patient survival conferred by older age of the donor in the context of the age of the recipient and of risk factors for graft and/or patient survival. The investigation was conducted in a single-center cohort of 5,359 consecutive first kidney transplants with adult deceased donors performed on non-prioritized adult recipients from January 1, 2002, to December 31, 2017. Death censored graft survival and patient survival were lower in older donors, whereas graft survival was higher and patient survival was lower in old recipients. The analyses of combinations of donor and recipient ages showed that death censored graft survival was lower in younger recipients in transplants from 18 to 59-year old donors, with standard or extended criteria, but no difference in graft survival was observed between younger and older recipients when the donor was ≥ 60-year old. Patient survival was higher in younger recipients in transplants with younger or older donors. Two to six HLA-A,B,DR mismatches, when compared to 0-1 MM, conferred risk for death-censored graft survival only in transplants from younger donors to younger recipients. Pre-transplant diabetes conferred risk for patient survival only in 50-59-year old recipients, irrespectively, of the age of the donor. Time on dialysis ≥ 10 years was a risk factor for patient survival in transplants with all donor-recipient age combinations, except in recipients with ≥ 60 years that received a kidney from an 18-49-year old donor. In conclusion, the results obtained in this study underline the importance of analyzing the impact of the age of the donor taking into consideration different scenarios.

show abstract

Section: Discussionsupporting

confidence: 92%

Impact of Combinations of Donor and Recipient Ages and Other Factors on Kidney Graft Outcomes

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Such results exclude the possibility that a female recipient lives longer than a male recipient to develop EBV-SMT, which is in line with several reports regarding the impact of gender on survival of POT patients. [35][36][37] Therefore, a possible higher risk for female POT patients to develop CNS EBV-SMT could be hypothesized; however, the patho-mechanism for this observation remains to be answered.…”

Section: Discussionmentioning

confidence: 99%

Role of surgery in treating epstein‐barr virus‐associated smooth muscle tumor (EBV‐SMT) with central nervous system invasion: A systemic review from 1997 to 2019

et al. 2021

View full text Add to dashboard Cite

Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) is a rare subset of spindle cell tumor. The presence of EBV DNA in smooth muscle tumor was first documented in 1994, and the term EBV-SMT was first described in 1995. 1-4 In the past few decades, patients at any age who were diagnosed with EBV-SMT, have been proved to have a strong correlation with immunodeficiency. 5-8 Cases of EBV-SMTs are most commonly correlated to secondary (or acquired) immunodeficiency, and the cases mainly consisted of patients with human immunodeficiency virus (HIV) infection 5,9-12 or with post-organ transplantation (POT) under immunosuppressants, 10,11,13 while a small

show abstract

“…Studies on outcome after renal transplantation based on the recipient's sex are much more difficult to interpret because there are conflicting data on the potential influence of the donor's sex [6][7][8][22][23][24][25][26][27]. In general, most studies have suggested that patient and graft survival is superior in men when compared to women [6][7][8], whereas few studies have shown a better 10 year-mortality rate in female recipients or no difference in death censored graft survival [25,26], respectively.…”

Section: Introductionmentioning

confidence: 99%

Sex disparities in dialysis initiation, access to waitlist, transplantation and transplant outcome in German patients with renal disease—A population based analysis

et al. 2020

View full text Add to dashboard Cite

Background Renal transplantation access and outcome differ between men and women, but no analysis has considered all transition phases and transplant outcome using the same data set. We analyzed sex disparities in all phases of patients’ clinical path (progression to dialysis, waitlisting, transplantation, graft failure/death). Methods In a population based approach using health insurance data (2005–2013) we examined patients’ risk of changing from one phase to another applying Cox Proportional Hazards model. Results After adjusting for age and comorbidities, women had a 16% lower risk of progression to ESRD (HR/95%-CI: 0.84/0.79–0.88). Access to the waitlist was lowered by 18% in women compared to men (HR/95%-CI: 0.82/0.70–0.96). An age stratified analysis did not reveal differences in any age group. Once waitlisted, the chance to receive a transplant was identical (HR/95%-CI: 0.96/0.81–1.15). The risk of transplant failure/death was identical for both sexes (HR/95%-CI: 0.99/0.73–1.35), but the effect was modified by age: in younger women (18–45 years) the risk was twice as high compared to men (HR/95%-CI: 2.08/1.04–4.14), whereas the risk in elderly women (> 65 years) was only half the risk of men (HR/95%-CI: 0.47/0.24–0.93). Conclusion Sex disparities occurred at different steps in the history of patients with renal disease and affected progression to dialysis, waitlisting and transplantation outcome in a population with equal access to medical treatment.

show abstract

Donor-recipient Sex Differences Do Not Affect Survival Outcomes After Kidney Transplantation: A Population Cohort Study

Cited by 14 publications

References 18 publications

Impact of Combinations of Donor and Recipient Ages and Other Factors on Kidney Graft Outcomes

Impact of Combinations of Donor and Recipient Ages and Other Factors on Kidney Graft Outcomes

Role of surgery in treating epstein‐barr virus‐associated smooth muscle tumor (EBV‐SMT) with central nervous system invasion: A systemic review from 1997 to 2019

Sex disparities in dialysis initiation, access to waitlist, transplantation and transplant outcome in German patients with renal disease—A population based analysis

Contact Info

Product

Resources

About