The Role of Donor Sex in Females Undergoing Repeat Kidney Transplant: Does Prior Donor Sex Matter?
Background. Female recipients of male donor kidneys are at increased risk for graft failure because of the HY antigen effect. However, whether prior transplant with a male donor impacts subsequent transplant outcomes is unknown. Therefore, the purpose of this study was to determine whether prior mal...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2022-08-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001352 |
| _version_ | 1797840181726806016 |
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| author | Stephanie Craig, MD Karthik Tennankore, MD Bryce Kiberd, MD George Worthen, MD Amanda Vinson, MD |
| author_facet | Stephanie Craig, MD Karthik Tennankore, MD Bryce Kiberd, MD George Worthen, MD Amanda Vinson, MD |
| author_sort | Stephanie Craig, MD |
| collection | DOAJ |
| description | Background. Female recipients of male donor kidneys are at increased risk for graft failure because of the HY antigen effect. However, whether prior transplant with a male donor impacts subsequent transplant outcomes is unknown. Therefore, the purpose of this study was to determine whether prior male-current male donor sex is associated with an increased risk of graft failure in female recipients.
Methods. We performed a cohort study of adult female recipients undergoing a second kidney transplant (2000–2017), identified using the Scientific Registry of Transplant Recipients. Using multivariable Cox models, we analyzed the risk of death-censored graft loss (DCGL) if the second transplant was from a male versus female kidney donor, conditional on donor sex at the time of the first transplant. In a secondary analysis, we stratified results by recipient age (>50 or ≤50 y) at the time of retransplant.
Results. Of 5594 repeat kidney transplants, 1397 (25.0%) developed DCGL. Overall, there was no association between first and second donor sex pairing and DCGL. A prior and current female donor (FD1FD2) posed a higher risk for DCGL in recipients aged >50 y at second transplant (hazard ratio,≤0.67, confidence interval 0.46-0.98, for all other donor combinations), but posed a lower risk if aged ≤50 y at retransplant (hazard ratio, ≥1.37, confidence interval 1.04-1.80, for all other donor combinations).
Conclusions. Overall, past-current donor sex pairing was not associated with DCGL in female recipients undergoing second kidney transplant; however, the risk with a past and current female donor was increased in older, and decreased in younger, female recipients at retransplant. |
| first_indexed | 2024-04-09T16:10:39Z |
| format | Article |
| id | doaj.art-fd8d91a7e5c34d16ba31e1037cad7a42 |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-04-09T16:10:39Z |
| publishDate | 2022-08-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-fd8d91a7e5c34d16ba31e1037cad7a422023-04-24T10:10:33ZengWolters KluwerTransplantation Direct2373-87312022-08-0188e135210.1097/TXD.0000000000001352202208000-00003The Role of Donor Sex in Females Undergoing Repeat Kidney Transplant: Does Prior Donor Sex Matter?Stephanie Craig, MD0Karthik Tennankore, MD1Bryce Kiberd, MD2George Worthen, MD3Amanda Vinson, MD41 Dalhousie University, Halifax, NS, Canada.1 Dalhousie University, Halifax, NS, Canada.1 Dalhousie University, Halifax, NS, Canada.1 Dalhousie University, Halifax, NS, Canada.1 Dalhousie University, Halifax, NS, Canada.Background. Female recipients of male donor kidneys are at increased risk for graft failure because of the HY antigen effect. However, whether prior transplant with a male donor impacts subsequent transplant outcomes is unknown. Therefore, the purpose of this study was to determine whether prior male-current male donor sex is associated with an increased risk of graft failure in female recipients. Methods. We performed a cohort study of adult female recipients undergoing a second kidney transplant (2000–2017), identified using the Scientific Registry of Transplant Recipients. Using multivariable Cox models, we analyzed the risk of death-censored graft loss (DCGL) if the second transplant was from a male versus female kidney donor, conditional on donor sex at the time of the first transplant. In a secondary analysis, we stratified results by recipient age (>50 or ≤50 y) at the time of retransplant. Results. Of 5594 repeat kidney transplants, 1397 (25.0%) developed DCGL. Overall, there was no association between first and second donor sex pairing and DCGL. A prior and current female donor (FD1FD2) posed a higher risk for DCGL in recipients aged >50 y at second transplant (hazard ratio,≤0.67, confidence interval 0.46-0.98, for all other donor combinations), but posed a lower risk if aged ≤50 y at retransplant (hazard ratio, ≥1.37, confidence interval 1.04-1.80, for all other donor combinations). Conclusions. Overall, past-current donor sex pairing was not associated with DCGL in female recipients undergoing second kidney transplant; however, the risk with a past and current female donor was increased in older, and decreased in younger, female recipients at retransplant.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001352 |
| spellingShingle | Stephanie Craig, MD Karthik Tennankore, MD Bryce Kiberd, MD George Worthen, MD Amanda Vinson, MD The Role of Donor Sex in Females Undergoing Repeat Kidney Transplant: Does Prior Donor Sex Matter? Transplantation Direct |
| title | The Role of Donor Sex in Females Undergoing Repeat Kidney Transplant: Does Prior Donor Sex Matter? |
| title_full | The Role of Donor Sex in Females Undergoing Repeat Kidney Transplant: Does Prior Donor Sex Matter? |
| title_fullStr | The Role of Donor Sex in Females Undergoing Repeat Kidney Transplant: Does Prior Donor Sex Matter? |
| title_full_unstemmed | The Role of Donor Sex in Females Undergoing Repeat Kidney Transplant: Does Prior Donor Sex Matter? |
| title_short | The Role of Donor Sex in Females Undergoing Repeat Kidney Transplant: Does Prior Donor Sex Matter? |
| title_sort | role of donor sex in females undergoing repeat kidney transplant does prior donor sex matter |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001352 |
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