WASHINGTON—Rates of live donor kidney (LDK) transplantation among women decreased from 1998 to 2018, widening the gender gap in receipt of an LDK, investigators reported at the American Society of Nephrology’s 2019 Kidney Week meeting.

Among 106,260 primary adult LDK transplants reported to the United Network for Organ Sharing/Organ Procurement and Transplantation Network from 1998 to 2018, the overall rate of LDK transplantation was 38.9% for women and 61.1% for men, Mariana Markell, MD, and Angelika Gruessner, MS, PhD, of SUNY Downstate Medical Center in Brooklyn, reported in a poster presentation. From 1998–2000 to 2016–2018, the overall rate of LDK transplantation for women declined from significantly from 41.9% to 36.7%.

Results also showed that white women were less likely to receive an LDK than non-white women. Compared with white women, black women and other non-white women had significant 32% and 12% greater odds of LDK transplantation, respectively. Women on dialysis had significant 21% decreased odds of LDK transplantation compared with those who had not started dialysis.

The investigators found that sensitized women had a significantly increased likelihood of receiving an LDK. A PRA value greater than 20% was significantly associated with 3.5-fold increased odds of receiving an LDK than a value of 20% or less.

In addition, women had significant 19% decreased odds of receiving an LDK from an unrelated donor than a related donor.

“The findings in this analysis suggest that the disparity in living donor receipt by women has worsened over the past 20 years, and that in fact, women who are sensitized are more likely to receive a living donor kidney than those who are not,” Dr Markell told Renal & Urology News. “In addition, the observation that the disparity differs across regions, and that women on dialysis are less likely to receive a live donor kidney, and women in general are less likely to receive an unrelated live donor kidney suggests that practice patterns may be more important than biological factors, which have been implicated in the past.”

Reference

Markell M, Gruessner A. Factors impacting the disparity in receipt of live donor kidneys by women vs men. Presented at the American Society of Nephrology’s 2019 Kidney Week meeting held November 5-10 in Washington, DC. Poster TH-PO1119.