Abstract: FR-PO880
Sex Disparities in Renal Transplant in Brazil: A Descriptive Analysis
Session Information
- Diversity and Equity in Kidney Health - II
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 800 Diversity and Equity in Kidney Health
Authors
- Diniz, Renan Gomes Mendes, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
- Morales, Natacha Ueda, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
- Lutf, Luciana Gil, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
- Strufaldi, Fernando Louzada, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
- Albuquerque, Claudia Coimbra, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
- Castro, Maria cristina R., Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
- David-Neto, Elias, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
Background
Social disparities in Health Care including sex, ethnic and socioeconomic ones are still prevalent and underestimated mainly in developing countries.
Methods
It was an epidemiological, retrospective and descriptive analysis comparing clinical data among men(M) and women(W) donor and recipients. Medical records from 2010-20 were collected in a center in Brazil. Variables were clinical and epidemiological data, comorbidities, pregnancies, transfusions, priority for end-stage vascular access failure (ESVAf), waiting list, immunologic profile, graft failure cause, mortality cause and rate and graft survival.
Results
A total of 1983 medical records were analyzed. The median age was 46,3y among men and 48,6 for women. A total of 48% were women and 52% men. Diabetes was equal among sexes, but more autoimmune diseases were seen in W. Among 437 relative living donors, W had a tendency to donate more than M (60Wx40%M) with mothers donating more than fathers (73W%xM27%). Among not-related donors, wives donate more than husbands (60%Wx40%M). About 75% of women had pregnancies before transplant. W also received more blood transfusions (58,4 x 47%, p=0,00001), data that also justifies the higher number of sensitized women (45% positive PRA in W x 18% in men; p=0,00001). Curiously, 27% of woman recipients were sensitized only due to pregnancies. Women rate in the priority list due to ESVAf were higher (4,9Wx3,7M%; p=0,00001) and they had more time on the waiting list (75Wx62M, P<0,005). There was a tendency for more deaths due to infection in W (54%Wx49%M) and cardiovascular reasons in M (9%Wx14%M); but patient 10y survival was the same (80%Wx78%M). Although not statistically different, graft survival at 10y was higher in women (88%Wx71%M).
Conclusion
Despite being a retrospective study, we included several variables of the disparities seen in renal transplantation. There was an association between being W renal recipients and sensitization, priority list inclusion due to ESVAf, number of transfusions and pregnancies, and time on the waiting list, variables that could be better approached in the future. Women looks like to donate more than men and although their higher risk at transplant, they present higher long-term graft survival, suggesting better self-care and adherence to treatment.