Member's paper - Kidney Health Education and Research Group

Abstract

Assessing the association between sex and access to living donor kidney transplantation (LDKT)

El-Dassouki, N., Dano, S., Richardson, C., Ahmed, T., Wasim, A., Moosa, S., Dychiao, A., Novak, M., Mucsi, I

2019

Canadian Society of Transplantation

Full Abstract
Background: Published studies suggest that women may experience lower kidney transplant rates than men. LDKT is the optimal treatment option for eligible patients with end-stage kidney disease (ESKD). To determine if women are disadvantaged in accessing LDKT, we assess the association between sex and readiness to pursue LDKT, having a potential living kidney donor (pLKD) identified, and receipt of LDKT offer. Methods: A cross-sectional, convenience sample of adult patients with ESKD from dialysis units in the Greater Toronto Area completed study questionnaires using an electronic data capture system. Clinical data was collected from electronic patient records. Sex was patient-identified (exposure). We assessed readiness to pursue LDKT (outcome) using a standard questionnaire. Participants also indicated if they had a pLKD identified or received an offer of LDKT (secondary outcome). Results: Of the 485 participants (mean[SD] age= 57[14] years), 38% were female, 44% were White, 22% were Asian, 30% were Black, 51% were married, 45% had diabetes, 65% were on dialysis for ≤3 years, and 35% were on dialysis for >3 years. After adjusting for sociodemographic variables, comorbidity, and ethnicity in a multivariable logistic regression model, females were more likely to have a pLKD identified than males (OR=1.7, CI=1.0-2.9, p=0.05). There was no significant difference in stage of LDKT readiness or having received an offer of LDKT between females and males. Conclusion: This study showed that females were more likely to have a pLKD identified, but there was no difference in LDKT readiness or having received an LDKT offer between sexes. Although these results suggest minimal disparities in access to LDKT between sexes in this population, previous studies have shown that women are less likely than men to complete pre-transplant workup or receive LDKT. Future studies should be done in representative samples to confirm our findings.

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