Impact of sex on clinical outcomes according to immunologic risk in spousal donor kidney transplantation

Seunghyeok Choi; Hanbi Lee; Sang Hun Eum; Ji-Won Min; Hye Eun Yoon; Chul Woo Yang; Byung Ha Chung

doi:10.23876/j.krcp.24.128

Impact of sex on clinical outcomes according to immunologic risk in spousal donor kidney transplantation

Kidney Res Clin Pract. 2024 Sep 11. doi: 10.23876/j.krcp.24.128. Online ahead of print.

Authors

Seunghyeok Choi¹, Hanbi Lee^{1

2}, Sang Hun Eum^{2

3}, Ji-Won Min^{2

4}, Hye Eun Yoon^{2

3}, Chul Woo Yang^{1

2}, Byung Ha Chung^{1

2}

Affiliations

¹ Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
² Transplantation Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
³ Division of Nephrology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
⁴ Division of Nephrology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

PMID: 39384345
DOI: 10.23876/j.krcp.24.128

Abstract

Background: The aim of this study is to investigate the impact of sex on the clinical outcomes of spousal donor kidney transplantation.

Methods: We analyzed 456 spousal donor kidney transplantation recipients and categorized them into standard or high immunological risk groups according to panel-reactive antibody ≥50% or less. There were 366 recipients in the standard-risk group and 89 recipients in the high-risk group.

Results: When comparing biopsy-proven allograft rejection within 1 year from kidney transplantation, husband-to-wife recipients showed significantly higher incidence than wife-to-husband recipients in the high-risk group. By contrast, there was no significant difference between wife-to-husband and husband-to-wife recipients in the standard-risk group. Allograft function recovery was better in husband-to-wife recipients than in wife-to-husband recipients in each group, while husband-to-wife recipients in the high-risk group showed a more rapid decline than other recipients. The long-term patient and allograft survival rates showed no difference between husband-to-wife recipients and wife-to-husband recipients within the same groups.

Conclusion: The husband-to-wife recipients with high immunological risk showed a higher risk of biopsy-proven allograft rejection compared to wife-to-husband recipients, so careful monitoring and management may be required.

Keywords: Donor-recipient sex; Graft rejection; Graft survival; Husband-to-wife recipient; S; Spousal donor kidney transplantation; Wife-to-husband recipient.