Tuohy Kathryn A, Johnson Scott, Khwaja Khalid, Pavlakis Martha
Transplant Center, Division of Nephrology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
Transplantation. 2006 Dec 15;82(11):1402-7. doi: 10.1097/01.tp.0000248953.64931.15.
Females are live kidney donors more often than males. We examined the pool of potential donors to determine at what point in the donor evaluation process this gender disparity develops.
We selected patients who underwent blood typing as potential live kidney donors for recipients being evaluated for transplantation at our center between January 2000 and January 2004. We reviewed patient records to determine when in the evaluation process elimination occurred: ABO incompatible, positive cross-match, no medical workup, medical workup incomplete, medical contraindication, social contraindication, recipient too sick or dead, approved but did not donate, or donated.
A total of 506 potential donors (55% female, 45% male) were evaluated. Males and females were equally likely to get through each step of the evaluation and be approved for donation. Overall, females were significantly more likely to donate than males. However, when approved donors are divided into those who were evaluated during the open nephrectomy (ON) era versus the laparoscopic nephrectomy (LN) era, the gender disparity among donors was present only in the ON era. In the ON era, there were 54 donors, 37 females and 17 males (P=0.004), whereas in the LN era, there were 61 donors, 32 females and 29 males (P=NS).
Among potential donors approved for donation, females have been significantly more likely to donate than males. The introduction of LN at our center was associated with a decrease in the gender difference in kidney donation.
女性作为活体肾供者的情况比男性更为常见。我们研究了潜在供者群体，以确定这种性别差异在供者评估过程的哪个阶段出现。
我们选取了2000年1月至2004年1月期间在本中心接受血型检测作为潜在活体肾供者的患者，这些供者为正在接受移植评估的受者提供肾脏。我们查阅患者记录，以确定在评估过程中的哪个阶段被排除：ABO血型不相容、交叉配血阳性、未进行医学检查、医学检查不完整、医学禁忌证、社会禁忌证、受者病情过重或死亡、已获批准但未捐赠或已捐赠。
共评估了506名潜在供者（55%为女性，45%为男性）。男性和女性通过评估的每个步骤并被批准捐赠的可能性相同。总体而言，女性捐赠的可能性明显高于男性。然而，当将已获批准的供者分为开放肾切除术（ON）时代和腹腔镜肾切除术（LN）时代进行评估的供者时，供者之间的性别差异仅存在于ON时代。在ON时代，有54名供者，37名女性和17名男性（P=0.004），而在LN时代，有61名供者，32名女性和29名男性（P=无显著性差异）。
在被批准捐赠的潜在供者中，女性捐赠的可能性明显高于男性。本中心引入腹腔镜肾切除术与肾脏捐赠的性别差异减少有关。
