ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO1119

Factors Impacting the Disparity in Receipt of Live Donor Kidneys by Women vs. Men

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Markell, Mariana S., SUNY Downstate Medical Center, Brooklyn, New York, United States
  • Gruessner, Angelika C., SUNY Downstate Medical Center, Brooklyn, New York, United States
Background

It was noted in the early 2000's that women received fewer live donor kidneys (LDK) than men. Since that time, more women have entered the workforce, transplantation of highly sensitized individuals has improved and there has been an increase in altruistic donation; factors that might improve the LDK transplant rate in women. We examined the rate of LDK transplants in women compared with men since 1998-00, as well as factors that might affect it.

Methods

All 105,729 primary adult living donor kidney transplants reported to UNOS/OPTN between 1998 and 2018 were analyzed. Only adult recipients were included in the analyses. The time period was divided into 3-year intervals to adjust for yearly fluctuations. Logistic regression models were used to assess the odds to receive a LDK for women adjusted for possible risk factors.

Results

The overall rate of LDK for women was 39%. Odds ratio (OR) for women vs men significantly worsened over time, with a OR of 0.866 (CI 0.845-0.93) for 2004-06, 0.756 (CI 0.719-0.795) in 2010-12 and 0.727 (CI 0.691-0.765) in 2016-18 compared to 1998-00. The OR decreased significantly with increasing age (>70yr, OR 0.192, CI 0.113-0.328). Interestingly, black women were more likely than whites (OR 1.315, CI 1.267-1.365), and women on dialysis were less likely than men (OR 0.791, CI 0.770, 0.813) to receive a LDK transplant. Women were also less likely to receive a non-biological kidney (whether spousal or altruistic) OR 0.806, CI 0.785-0.828, but women with a PRA >20 had a much higher chance of receiving a LDK (OR 3.547 CI 3.389-3.712).

Conclusion

1. The gender disprity in LDK rate for women has worsened since 1998-00, with a 28% difference in 2016-18. 2. Older women have the least likelihood of receiving a live donor kidney, with women over the age of 70 years 80% less likely. 3. Black women are more likely than whites to receive a LDK. 4. Women on dialysis are 20% less likely to receive a kidney than those who have not yet started. 6. Although biological reaons have been postulated in the past to explain gender disparity, the above findings and the observations that women who are sensitized are 3.5 times more likely to receive a live donor kidney than those who are not and that women are less likely to recieve a non-biologically related kidney suggests that sociocultural and practice patterns may be more important and should be investigated further.