Gender imbalance among donors in living kidney transplantation:: the Norwegian experience

Background. In living donor (LD) kidney transplantation, a predominance of female-to-male donations has been observed. Gender demographics of living donors and outcomes of LD kidney transplantations in Norway were assessed, as this has not been explored previously. Methods. Data from the Norwegian Renal Registry of first LD kidney transplantations (n = 1319) in the period 1985-2002 were used. Results. The majority of all LD was female (57.8%; P < 0.001), while 62.7% of the recipients were men (P < 0.001). Females dominated as donors in the spousal group and the parental group (P < 0.0001). However, no gender difference was observed in the parental group when the recipients were < 30 years old (P=0.65). In opposite-sex pairs, female-to-male donations were as expected based on the incidence of end-stage renal disease. Donor sex affected neither the incidence of acute rejections nor graft survival. Serum creatinine was higher in renal allografts from female donors to male recipients in the first 4 years after transplantation. Donor age also had significant impact on graft function measured as serum creatinine. Conclusions. Gender disparities in LD transplantation result from a higher proportion of female-to-female and a lower proportion of male-to-male donations than expected. Both donor age and donor sex influence graft function during the first years. Graft survival and acute rejection episodes appear not to be affected by donor sex in LD kidney transplantation.