Gender Bias in Kidney Donation in India: Has It Changed Over the Past 2 Decades?

To study the trend among Indian women living kidney donation over the past 18 years and see if a gender bias still exists as described in literature before.

This is a retrospective, single-center, observational cohort study with data collected from the medical records department of all living donor kidney transplants between January 2001 to December 2018, which were categorized into 2 groups of 9 years each for comparison using categorical variables in form of number, percentage, χ² test, and Pearson correlation coefficient.

A total of 557 kidney transplants were analyzed, with women having 78.5% higher incidence of donation (P < .001). Among them, parents (72.20% mothers), spouses (87.20% wives), siblings (47.50% sisters), and children (44.44% daughters) were the major participants. Further analysis revealed wife donation reduced from 92.3% to 85.6% (P = .41) and mother donation reduced from 72.5% to 71.7% (P = .91), whereas sister donation increased from 28.5% to 51.5% (P = .14) and daughter donation increased from 0% to 44.4% during the 18-year period. Also, female to male donation decreased from 63.8% to 51.6% (P = .02) during the same period. Thus, the overall percentage of female donation is decreasing (73.9% to 61.4%, P = .01), and a significant negative correlation with time was observed in this study (correlation coefficient, r = -0.55, P = .017).

A lot has changed over the past 18 years, with more male kidney donors now coming forward. Larger prospective studies are required to understand the diverse reason for this sex discrepancy.