Gender disparity in living renal transplant donation

Numerous studies document that women constitute the majority of living kidn ey donors, but the reasons behind the disparity in donation rates between m en and women remain obscure. We studied this issue by gathering data on fam ily members of living donor allograft recipients at a single large center o ver a B-year period (n = 144). By considering all potential donors (spouses and first-degree relatives) within each recipient's immediate family, we d etermined that men and women are excluded as donors at approximately simila r rates on the basis of medical condition or known blood group type A, type B, type O incompatibility, and that a greater percentage of acceptable fem ale donors (28.3%) compared with men (20.3%) go on to donate a kidney (P = 0.027), However, when only first-degree relatives are considered, the diffe rence in donation rate between men and women becomes nonsignificant (26.9% of women versus 22.2% of men; P = 0.229), Among spouses, the gender dispari ty in donation rate is greater (36% of wives versus 6.5% of husbands who ar e acceptable donors go on to donate a kidney; P = 0.003). Evidence that eco nomic factors may contribute to the overall gender disparity is also presen ted. In conclusion, the gender disparity among living kidney donors observe d in our population can be largely attributed to an overwhelming predominan ce of wives among spousal donors. Possible explanations and potential inter ventions to address underrepresentation of male donors are discussed. (C) 2 000 by the National Kidney Foundation, Inc.