Effect of Donor Sex on Graft Outcomes After Living Donor Kidney Transplant

Transplant is increasingly recognized as a better alternative to dialysis for patients with endstage renal disease, with living donor transplants generally showing better outcomes. Despite insights into the influence of various donor and recipient factors, the role of donor sex in transplant outcomes remains underexplored. We evaluated recipient outcomes of female donor kidneys compared with outcomes of male donor kidneys in living donor kidney transplant.

We conducted a retrospective analytic cohort study involving 250 patients 18 years and older who underwent living donor kidney transplant. All transplants were performed between related individuals (up to fourth degree). Participants were categorized based on donor-recipient sex combinations, and outcome measures included immediate graft function, delayed graft function, slow graft function, rejection rates, and post-transplant serum creatinine trends.We used Kaplan-Meier survival curves to assess graft and patient survival. We used statistical software for data analysis, incorporating chi-square tests, t tests, analysis of variance, Cox proportional hazards modeling, and log-rank tests.

Among the 250 transplants analyzed, donor demographics revealed near equality in male and female donors (124 female vs 126 male donors), with a significant majority of male recipients (n = 213). The study found no significant differences between male and female donors concerning graft function and post-transplant serum creatinine levels. However, male recipients consistently exhibited higher serum creatinine levels versus female recipients. Although graft and patient survival rates did not differ significantly across sex combinations,female recipients demonstrated consistently better outcomes.

Our study indicated that female donors do not negatively affect immediate graft function or short-term outcomes in living donor kidney transplants.