Vavallo Antonio, Lucarelli Giuseppe, Spilotros Marco, Bettocchi Carlo, Palazzo Silvano, Selvaggi Francesco Paolo, Battaglia Michele, Ditonno Pasquale
Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Piazza G. Cesare 11, 70124, Bari, Italy.
World J Urol. 2014 Jun;32(3):709-14. doi: 10.1007/s00345-013-1137-9. Epub 2013 Aug 2.
Donor and recipient gender influence on post-transplant kidney and patient survival is still controversial, and the literature data do not present unanimous conclusions. The aim of this study was to evaluate the effect of gender disparities between donor and recipient in 963 kidney transplants performed at our center from January 2000 to December 2010.
The patients were subdivided into four groups according to recipient and donor gender: male donor-to-male recipient (MDMR; n = 305), male donor-to-female recipient (MDFR; n = 203), female donor-to-female recipient (FDFR; n = 206), and female donor-to-male recipient (FDMR; n = 249). Independent sample's t test and one-way ANOVA were used for statistical analyses. Graft and patient survival were calculated by the Kaplan-Meier method and compared using the log rank test.
There were no statistically significant differences between the groups with regard to age, cold ischemia time, delayed graft function, primary non-function, and episodes of acute and chronic rejection. Moreover, no difference in either graft (p = 0.92) or patient (p = 0.41) survival at 1, 3, and 5 years was observed. However, female recipients had significantly lower serum creatinine values and higher estimated GFR, particularly if they received a male donor kidney, and these findings were stable up to 3-year post-transplantation.
No impact of gender on short- or long-term graft and patient survival was observed in deceased kidney transplantation. However, we report a lower creatinine level in the male donors to female recipients group as compared with other recipient-donor gender combinations, although this difference loses statistical significance after the third-year post-transplantation.
供体和受体性别对肾移植术后肾脏及患者存活的影响仍存在争议，文献数据并未得出一致结论。本研究的目的是评估2000年1月至2010年12月在我们中心进行的963例肾移植中供体与受体之间性别差异的影响。
根据受体和供体性别将患者分为四组：男性供体至男性受体（MDMR；n = 305）、男性供体至女性受体（MDFR；n = 203）、女性供体至女性受体（FDFR；n = 206）以及女性供体至男性受体（FDMR；n = 249）。采用独立样本t检验和单因素方差分析进行统计分析。通过Kaplan-Meier方法计算移植物和患者存活率，并使用对数秩检验进行比较。
各组在年龄、冷缺血时间、移植肾功能延迟恢复、原发性无功能以及急慢性排斥反应发作方面均无统计学显著差异。此外，在1年、3年和5年时，移植物（p = 0.92）或患者（p = 0.41）存活率均未观察到差异。然而，女性受体的血清肌酐值显著较低，估计肾小球滤过率较高，如果她们接受男性供体肾脏尤其如此，并且这些结果在移植后3年内保持稳定。
在尸体肾移植中未观察到性别对短期或长期移植物及患者存活有影响。然而，我们报告男性供体至女性受体组的肌酐水平低于其他受体 - 供体性别组合，尽管这种差异在移植后第三年失去统计学意义。
