Age-dependent Sex Differences in Graft Loss After Kidney Transplantation.

Autor:	Vinson AJ; Nephrology Division, Department of Medicine, Dalhousie University, Halifax, NS, Canada., Zhang X; Research Institute of the McGill University Health Centre, Montréal, QC, Canada., Dahhou M; Research Institute of the McGill University Health Centre, Montréal, QC, Canada., Süsal C; Institute of Immunology, Heidelberg University Hospital, Heidelberg, Germany., Döhler B; Institute of Immunology, Heidelberg University Hospital, Heidelberg, Germany., Sapir-Pichhadze R; Department of Medicine, Division of Experimental Medicine, McGill University, QC, Canada., Cardinal H; Department of Medicine, Division of Nephrology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada., Melk A; Children's Hospital, Hannover Medical School, Hannover, Germany., Wong G; School of Public Health, University of Sydney, Sydney, NSW, Australia., Francis A; School of Clinical Medicine, University of Queensland, QLD, Australia.; Department of Nephrology, Queensland Children's Hospital, Brisbane, Australia., Pilmore H; Department of Renal Medicine, Auckland City Hospital, Auckland, New Zealand., Foster BJ; Research Institute of the McGill University Health Centre, Montréal, QC, Canada.; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.; Department of Pediatrics, Division of Nephrology, McGill University Faculty of Medicine, QC, Canada.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2022 Jul 01; Vol. 106 (7), pp. 1473-1484. Date of Electronic Publication: 2021 Dec 28.
DOI:	10.1097/TP.0000000000004026
Abstrakt:	Background: Sex differences in kidney graft loss rates were reported in the United States. Whether these differences are present in other countries is unknown. Methods: We estimated the association between recipient sex and death-censored graft loss in patients of all ages recorded in the Scientific Registry of Transplant Recipients, Australia and New Zealand Dialysis and Transplant Registry, and Collaborative Transplant Study registries who received a first deceased donor kidney transplant (1988-2019). We used multivariable Cox regression models, accounting for the modifying effects of donor sex and recipient age, in each registry separately; results were combined using individual patient data meta-analysis. Results: We analyzed 438 585 patients. Young female patients 13-24 y old had the highest crude graft loss rates (female donor: 5.66; male donor: 5.50 per 100 person-years). Among young recipients of male donors, females showed higher graft loss risks than males (0-12 y: adjusted hazard ratio [aHR] 1.42, (95% confidence interval [CI], 1.17-1.73); 13-24 y: 1.24 (1.17-1.32); 25-44 y: 1.09 (1.06-1.13)). When the donor was female, there were no significant differences by recipient sex among those of age <45 y; however, the aHR for females was 0.93 (0.89-0.98) in 45-59 y-old and 0.89 (0.86-0.93) in ≥ 60 y-old recipients. Findings were similar for all 3 registries in most age intervals; statistically significant heterogeneity was seen only among 13-24-y-old recipients of a female donor (I2 = 71.5%, P = 0.03). Conclusions: There is an association between recipient sex and kidney transplantation survival that is modified by recipient age and donor sex. Competing Interests: A.J.V. has accepted consulting fees and fellowship grant funding from Paladin Labs Inc. A.M. is supported by grants from the German Research Foundation (DFG; ME 3696/5-1 and ME3696/3-1) and the Lower Saxony Ministry of Science and Culture. G.W. is supported by NHMRC Investigator (APP 1195414) and Career Development Fellowship (APP 1147657). R.S.-P. is supported by a Fonds de recherche du Quebec—Santé chercheur boursier clinician award (grant no. 254386) and CIHR (grant FRN-156730). This study was supported by funding from the Canadian Institutes of Health Research PJT-165832. The other authors declare no conflicts of interest. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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