Kidney Week

Abstract: PUB523

Donor Sex Disparities in CKD Progression: A UNOS Analysis

Session Information

• Publication Only

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Cabezas, Fausto Ricardo, SUNY Downstate Health Sciences University, New York City, New York, United States

Fausto Ricardo Cabezas, MD

• Roche-Recinos, Andrea, SUNY Downstate Health Sciences University, New York City, New York, United States

Andrea Roche-Recinos, MD

• Saggi, Subodh J., SUNY Downstate Health Sciences University, New York City, New York, United States

Subodh J. Saggi, MD, MPH

• Gruessner, Angelika C., SUNY Downstate Health Sciences University, New York City, New York, United States

Angelika C. Gruessner, PhD

Background

Living donor kidney transplantation (LDKT) remains the gold standard for the treatment of ESRD. However, there is scarce prospective data on long term outcomes for kidney donors. Retrospective studies with follow-up time of 10 years or more have shown a modest risk increase in all-cause mortality, hypertension and ESRD. As a higher proportion of living donors are female, we aim to assess sex disparities amongst kidney donors requiting listing for kidney transplantation (KT).

Methods

We queried the UNOS/OPTN database for all adults listed for a primary KT between 1/1/2014 and 12/31/23. Probabilistic linkage was used to link the donor record to the waitlist information. Comprehensive statistical methods were applied to assess the development over time and to describe possible sex differences.

Results

51,700 primary LDKTs performed during the study period, 64% of donors were female (p=0.007). In contrast, of 519 donors (1%) who were listed for KT, 64% were male (p<0.0001) (fig 1). Baseline characteristics were similar in between the groups (table 1). Only males were more likely to have hypertension and diabetes at the time of listing. There was no significant difference in time from donation to listing between the groups.

Conclusion

Male kidney donors are more likely to progress to require kidney transplant listing. Higher rates of diabetes and hypertension are likely associated with faster decline in kidney function amongst males. Prospective research assessing long term outcomes in donors is warranted.

Table 1. Baseline Characteristics

Figure 1. Rate of female LDKT donors and waitlisting