H-Y incompatibility predicts short-term outcomes for kidney transplant recipients

J Am Soc Nephrol. 2009 Sep;20(9):2025-33. doi: 10.1681/ASN.2008101110. Epub 2009 Jun 18.

Abstract

A recent report suggested that female recipients of male deceased-donor kidneys are at increased risk for graft failure because of H-Y antigen mismatch. In an attempt to confirm and extend these results, we studied all adult recipients of deceased-donor kidney transplants from 1990 through 2004 in the US Renal Data System. Compared with all other gender combinations, female recipients of male donor kidneys had a 12% increased risk for graft failure at 1 yr (hazard ratio 1.12; 95% confidence interval 1.05 to 1.19) but no excess risk at 10 yr (hazard ratio 1.03; 95% confidence interval 0.98 to 1.07). We observed a similar pattern of short- and long-term risk for both death-censored graft failure and mortality. The main results were consistent across several prespecified patient subgroups and were robust to sensitivity analyses. In conclusion, compared with other recipient-donor gender combinations, female recipients of male donor kidney transplants in the United States have an increased short-term risk but not long-term risk for adverse outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Graft Rejection / immunology*
  • Graft Rejection / mortality*
  • H-Y Antigen / immunology*
  • Histocompatibility / immunology
  • Humans
  • Isoantibodies / immunology
  • Kaplan-Meier Estimate
  • Kidney Transplantation / immunology*
  • Kidney Transplantation / mortality*
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Risk Factors
  • Sex Distribution
  • Tissue Donors / statistics & numerical data
  • Young Adult

Substances

  • H-Y Antigen
  • H-Y antibody
  • Isoantibodies