Sex Differences in Transplantation Survival Benefit

For patients with kidney failure who require renal replacement therapy, the preferred treatment is kidney transplantation. There are few data on whether the survival benefit is different for men and women. 

Angelika Geroldinger, PhD, and colleagues conducted a study that included all patients receiving dialysis included in the Austrian Dialysis and Transplant Registry who were waitlisted for their first kidney transplant between 2000 and 2018. The researchers mimicked a series of controlled trials and applied inverse probability of treatment and censoring-weighted sequential Cox models to estimate the causal effect of kidney transplantation on 10-year restricted mean survival time. 

The study cohort included 4408 patients. Of those, 33% were female and mean age was 52 years. In both women and men, the most common primary renal disease was glomerulonephritis (27% and 28%, respectively).  

Over a 10-year follow-up, kidney transplantation led to a gain of 2.22 years (95% CI, 1.88-2.49) over dialysis. The effect was smaller in women than in men (1.95 years [95% CI, 1.38-2.41] vs 2.35 years [95% CI, 1.92-2.70], respectively). The survival benefit of transplantation over the follow-up period was smaller in younger women and increased with age. In both men and women, the survival benefit peaked at approximately age 60 years. 

In summary, the authors said, “There were few differences in survival benefit by transplantation between females and males. Females had better survival than males on the waitlist receiving dialysis and similar survival to males after transplantation.” 

Source: Nephrology Dialysis Transplantation