The main role of the kidneys is to filter waste products from the blood and convert them to urine. If the kidneys lose this ability, waste products can build up, which is potentially life-threatening, so a kidney transplant is the treatment of choice for kidney failure whenever possible. Research published in the Journal of the American Society of Nephrology shows the success of kidney transplant is dependent on the age and sex of both the donor and the recipient.
‘Unlike many other types of organ donation, it's possible to donate a kidney while you're alive because you only need one kidney to survive.’
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The study, which was a collaboration between a team from the Research Institute of the McGill University Health Centre (RI-MUHC) and the University of Montreal Hospital Research Center (CRCHUM), revealed that young women had poorer transplant outcomes compared to young men, whereas women of post-menopausal age had similar or slightly better outcomes than men of the same age. This finding opens the door to a new approach for organ transplantation, and could lead to personalized immunosuppression strategies based on age and sex. "This is the first study to assess differences in graft outcomes between female and male recipients across the entire age spectrum," says the study's corresponding author Dr. Beth Foster, researcher at the RI-MUHC and pediatric nephrologist at the Montreal Children's Hospital of the MUHC. "Previous studies did not find significant differences in graft survival between the sexes, but they focused exclusively on adults, most of whom were older. We considered the possibility that sex differences in graft survival may depend on age."
The researchers evaluated the records of nearly 160,000 kidney transplant recipients recorded in the Scientific Registry of Transplant Recipients database, which includes all transplant recipients in the United States. The outcomes of graft success were evaluated in relation to the age and sex of both the recipient and the donor.
"We found that among recipients of male donors, females of all ages had significantly worse graft survival than males," explains first author Dr. Fanny Lepeytre, fellow in Nephrology at the CRCHUM for this project. "However, when the donor was female, only female recipients aged 15-24 years had worse outcomes than their male counterparts. In fact, female recipients aged 45 years or older actually had slightly better graft survival than males of the same age when the donor was female."
The role of sex hormones in graft outcomes
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Another possible explanation for the sex differences observed in this study is that sex hormones may influence the function of anti-rejection medications, making them less effective in females than males.
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"We need to better understand which biological and social factors explain the sex differences in graft outcomes that we observed," says Dr. Foster. "Right now, we treat men, women, boys and girls with transplants in a very similar way. With better understanding we could potentially improve graft outcomes by developing age and sex specific immune-suppression strategies."
Source-Eurekalert