Gender differences in renal transplant graft survival.

BACKGROUND/PURPOSE A long-term retrospective study was conducted to assess the risk factors of renal transplant graft failure focusing on the effects of gender of both the donor and the recipient. METHODS Medical records of primary renal transplantation performed in a single transplant hospital were reviewed. Cases of ABO incompatibility, positive cross-matches, or multiple organ transplants were excluded. A total of 766 patient records were reviewed, and variables were analyzed with Kaplan-Meier survival curves and Cox regression to determine the independent factors associated with graft survival. RESULTS The overall 5-year graft and patient survival rates were 84.7% and 92.2%, respectively. Univariate analysis showed significantly poorer prognosis in male patients and in those with acute rejection, delayed function, or more mismatches in human lymphocyte antigens. Multivariate analysis with step-wise regression identified three independent prognostic factors for poor graft survival (male gender, acute rejection, and delayed function). The 5-year graft survival rates for female and male patients were 87.9% and 81.3%, respectively. The risk ratio of graft failure for male renal transplant recipients was 1.3732, when compared with that for female patients. The risk ratios for those with acute rejection and delayed function were 1.8330 and 1.5422, respectively. CONCLUSION Male gender, in addition to acute rejection and delayed function, was found to be an independent prognostic factor for poor renal transplant survival in this long-term retrospective study.