Kurtis J. Swanson, Fahad Aziz, Neetika Garg, Didier Mandelbrot, Sandesh Parajuli
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The univariate and multivariate risks for AR and graft failure were conducted using the Cox proportional hazards model and log-rank tests.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 130 donors, 84 male and 46 female fulfilled our selection criteria and were transplanted in 260 recipients. With respect to the concordant groups (M-m or F-f), sex discordance was not significantly associated with the risk of rejection in multivariate analysis (M-f vs. M-m HR 1.15 [0.53–2.53, <i>P</i> = 0.72]; F-m vs. F-f HR 1.77 [0.71–4.39, <i>P</i> = 0.23]). Sex discordance was also not significantly associated with graft failure in multivariate analysis. Interestingly, risk factors for AR differed among male donors and female donors. 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引用次数: 0
摘要
导言：对来自同一供体的已故供体肾移植（DDKT）受体与供体-受体性别不一致的结果进行了研究，但结果并不一致：方法：研究对象包括在本中心接受了来自同一供体的两个不同性别受者的成人肾移植。根据供体和受体性别的一致或不一致，分别分析男性和女性供体的结果：男性-男性（M-m）与男性-女性（M-f）或反之，F-f与F-m。急性排斥反应（AR）和未删减的移植物失败是研究的主要结果。采用 Cox 比例危险度模型和对数秩检验对急性排斥反应和移植物失败的单变量和多变量风险进行了分析：共有 130 名供体（84 名男性和 46 名女性）符合我们的选择标准，并移植给了 260 名受体。在多变量分析中，性别不一致与排斥反应风险无显著相关性（M-f vs. M-m HR 1.15 [0.53-2.53, P = 0.72]；F-m vs. F-f HR 1.77 [0.71-4.39, P = 0.23]）。在多变量分析中，性别不一致与移植失败也无明显关联。有趣的是，男性捐献者和女性捐献者的 AR 风险因素有所不同。计算出的面板反应性抗体（cPRA）较高和非白人受者在F-m中发生AR的风险增加，而在M-f中则没有：结论：供体与受体性别不一致与 AR 或移植物失败无明显关系。男性和女性捐献者发生 AR 的风险因素可能有所不同。
Outcomes of Deceased Donor Kidney Recipients From the Same Donor Based on Donor–Recipient Sex Discordance
Introduction
Outcomes of deceased donor kidney transplant (DDKT) recipients from the same donor with donor–recipient sex discordance have been studied with inconsistent results.
Methods
Adult DDKT where both kidneys from the same donor occurred at our center in two different recipients of different sexes were included. Outcomes were analyzed separately for male and female donors, based on the concordance or discordance between donor–recipient sex: Male-male (M-m) versus Male to female (M-f) or vice versa, F-f versus F-m. Acute rejection (AR) and uncensored graft failure were primary outcomes of interest. The univariate and multivariate risks for AR and graft failure were conducted using the Cox proportional hazards model and log-rank tests.
Results
A total of 130 donors, 84 male and 46 female fulfilled our selection criteria and were transplanted in 260 recipients. With respect to the concordant groups (M-m or F-f), sex discordance was not significantly associated with the risk of rejection in multivariate analysis (M-f vs. M-m HR 1.15 [0.53–2.53, P = 0.72]; F-m vs. F-f HR 1.77 [0.71–4.39, P = 0.23]). Sex discordance was also not significantly associated with graft failure in multivariate analysis. Interestingly, risk factors for AR differed among male donors and female donors. The higher calculated panel reactive antibodies (cPRA) and nonwhite recipients were at increased risk for AR in F-m, but not in M-f.
Conclusions
Donor–recipient sex discordance was not significantly associated with AR or graft failure. Risk factors for AR may differ across male and female donors.
期刊介绍：
Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored.
Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include:
Immunology and immunosuppression;
Patient preparation;
Social, ethical, and psychological issues;
Complications, short- and long-term results;
Artificial organs;
Donation and preservation of organ and tissue;
Translational studies;
Advances in tissue typing;
Updates on transplant pathology;.
Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries.
Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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