Gender differences in the risk for chronic renal allograft failure

H. U. Meier-Kriesche, A. O. Ojo, S. F. Leavey, J. A. Hanson, A. B. Leichtman, J. C. Magee, D. M. Cibrik, Bruce Kaplan

    Research output: Contribution to journalArticlepeer-review

    77 Scopus citations


    Background. Despite the known differences in immunological reactivity between males and females, no differences in graft survival have been described among renal transplant recipients with regard to gender. To address this paradox, we analyzed data from 73,477 primary renal transplants collected in the US Renal Data System database. Methods. Logistic regression and Cox proportional hazard models were used to investigate the primary study end points, graft loss secondary to acute rejection (AR) or chronic allograft failure (CAF). CAF was defined as graft loss beyond 6 months, not attributable to death, recurrent disease, acute rejection, thrombosis, infection, noncompliance, or technical problems. The models adjusted for 15 covariates including immunosuppressive regimen, and donor and recipient characteristics. Results. The overall 8-year graft and patient survivals were significantly better in female renal transplant recipients compared with male recipients. However graft survival censored for death was not significantly different by gender. By multivariate analysis, females had a 10% increased odds of AR (OR=1.10, CI 1.02-1.12), but conversely a 10% lower risk of graft loss secondary to CAF (RR=0.9, CI 0.85-0.96). The risk for CAF increased significantly with increasing age for both males and females, but this effect was greater for males than for females (P<0.001). Conclusion. Although female renal transplant recipients have a similar death censored graft survival compared with males, there are important differences in immunological behavior. Females have a higher risk of AR while having a decreased risk of graft loss secondary to CAF.

    Original languageEnglish (US)
    Pages (from-to)429-432
    Number of pages4
    Issue number3
    StatePublished - Feb 15 2001

    ASJC Scopus subject areas

    • Transplantation


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