Elsevier

Transplantation Proceedings

Volume 39, Issue 10, December 2007, Pages 2961-2963
Transplantation Proceedings

Organ donation
Gender Bias in Renal Transplantation: Are Women Alone Donating Kidneys in India?

https://doi.org/10.1016/j.transproceed.2007.08.089Get rights and content

Abstract

Previous studies have shown that women not only donate live-related and unrelated kidneys more often, but are also less likely to receive a live kidney than men. Few data are, however, available from developing countries. To study a possible gender imbalance in living donor (LD) renal transplantation in India, we retrospectively analyzed all LD renal transplantations performed at a single center between 2001 and 2005. Of the 682 recipients, 606 (88.9%) were males and 76 (11.1%) were females (P < .0001). There were 552 biologically related, 118 spousal, and 12 unrelated nonspousal donors. Among the donors, there were 451 (66.1%) females and 231 (33.9%) males (P < .001). Most of the live donations were contributed by mothers (32.1%). In the spousal group, the greatest gender disparity was observed with predominantly wives donating for their husbands (90.7% vs 9.3%). Complex social and economic factors are responsible for the overall gender imbalance. In conclusion, women represent a highly vulnerable group in LD renal transplantation. Awareness and changes in attitudes of the public as well as physicians are needed to eliminate this gender inequity.

Section snippets

Methods

The study was a retrospective single center review conducted at our institute, a tertiary care facility servicing the population of Northern India. Records of all consecutive living related and living unrelated kidney transplantations between 2001 and 2005 were reviewed. Variables examined included recipient and donor age, gender, date of transplantation, underlying basic disease, HLA typing, and relationship of donor to patient. Cadaveric transplantations were excluded. The data were analyzed

Results

The annual incidence of ESRD reported in India varies from 34 to 240 per million population.9 An average of 840 new cases of ESRD are registered every year at our institute. In all, 1031 recipient-donor pairs were worked up as potential candidates for renal transplantation between 2001 and 2005. Among these, 695 (67.4%) were females and 336 (32.6%) were males (P < .001). There were a total of 682 donors and recipients in the study period. Of the 682 recipients, 606 (88.9%) were males and 76

Discussion

In our study from a single center, males received significantly greater numbers of living donor renal transplants than their female counterparts. Studies from developed nations such as the United States,4 Sweden,5 and Canada10 have also shown a similar gaping gender disparity in access to obtaining renal transplants. Few reports are, however, available from developing countries where the situation is expected to be even worse. A 1998 study from India by Avula et al11 reported a 16%

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