Purpose: In renal transplantation, the donor age and allograft size are important factors for the outcome of the graft and might be indicators of a functioning renal mass. Females tends to have smaller kidneys, which have 17% fewer nephrons than males, and the number of glomeruli per kidney as well as the mean glomerular volume are closely correlated with the kidney weight and negatively correlated with age. This study evaluated the impact of gender and age matching on the long-term graft survival in a living donor renal transplant.
Methods: 614 renal transplants, patients were divided into 4 groups according to the donor and the recipient´s gender: Group 1 was male donor to male recipient, Group 2 was male donor to female recipient, group 3 was female donor to male recipient, group 4 was female donor to female recipient. The long-term graft survival and risk factors among the four groups were analyzed. In addition graft survival was also analyzed according to age matching in each groups. Statistical significance was determined using the Kaplan- Meier method and a log rank test (P＜0.05).
Results: The graft survival rates at 1, 3, 5, 10 years were 92.6%, 88.1%, 82.4%, 76.1% respectively. The risk factors affecting the long-term graft survival were the donor age, the donor gender, the acute rejection rate, and HLA-DR matching. The graft survival rates of group 3 (female donor to male recipient) showed significant differences compared to the other groups (P=0.0165). In addition, the long-term graft survival rates of the older donors (donor age＞recipient age) were better than the younger donor (donor age＜recipient age) in each groups (P=0.0213).
Conclusion: The importance of an inadequate renal mass was magnified in the high risk recipients and age matching might improve the results of transplantation, particularly from older donors. Therefore, the age and gender should be considered as criteria in choosing donors and recipients in organ allocation.
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