Gender aspects in kidney transplantation

Abstract

Successful kidney transplantation is the best treatment for patients with end stage renal disease and graft survival is one of the most important measures of success in kidney transplantation. The majority of the patients with end stage renal disease is men while the majority of living donors is women. Gender related issues in the demographics of the living donor population and outcomes in the transplant recipients are elucidated in this thesis.<br><br>

When evaluating the gender distribution in living donors and graft survival in first time living donor kidney transplant recipients, data was retrieved from the Norwegian Renal Registry during two different time periods. Gender demographics of living donors and outcomes were evaluated in 1319 first time transplantations performed in the period 1985-2002. Death censored graft survival and acute rejection episodes were investigated in 739 first time living donor transplantations in recipients 18 years of age or older performed between 1994 and 2004. Gender differences in cardiovascular events and total mortality in recipients of a kidney transplant was evaluated in the placebo arm of the ALERT (Assessment of LEscol in Renal Transplantation) study (n=1052),<br><br>

The aim of this thesis was to increase our knowledge about gender related issues in kidney transplantation. The main results are that in Norway there is no predominance of female-to-male donations among first time living donor kidney transplantations. Donor age up to 65 years provided excellent long term results in living donor transplantation. Furthermore, female donor sex may convey superior long term graft survival compared to male donor sex. No gender difference in cardiac events or total mortality was found in a relatively low risk population of transplant recipients. This result suggests that the female gender advantage regarding cardiovascular heart disease is not restored by transplantation.