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Gender in the allocation of organs in kidney transplants: meta-analysis.

Santiago EV, Silveira MR, Araújo VE, Farah Kde P, Acurcio Fde A, Ceccato Md - Rev Saude Publica (2015)

Bottom Line: Meta-analysis was conducted with the Review Manager® 5.2 software, through the application of a random effects model.Comparison between recipient genders was not found to have significant differences on any evaluated follow-up periods.In the evaluation between donor-recipient genders, male donor-male recipient transplants were favored in a statistically significant way.

View Article: PubMed Central - PubMed

Affiliation: Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, BR.

ABSTRACT

Unlabelled: OBJECTIVE To analyze whether gender influence survival results of kidney transplant grafts and patients.METHODS Systematic review with meta-analysis of cohort studies available on Medline (PubMed), LILACS, CENTRAL, and Embase databases, including manual searching and in the grey literature. The selection of studies and the collection of data were conducted twice by independent reviewers, and disagreements were settled by a third reviewer. Graft and patient survival rates were evaluated as effectiveness measurements. Meta-analysis was conducted with the Review Manager® 5.2 software, through the application of a random effects model. Recipient, donor, and donor-recipient gender comparisons were evaluated.

Results: Twenty-nine studies involving 765,753 patients were included. Regarding graft survival, those from male donors were observed to have longer survival rates as compared to the ones from female donors, only regarding a 10-year follow-up period. Comparison between recipient genders was not found to have significant differences on any evaluated follow-up periods. In the evaluation between donor-recipient genders, male donor-male recipient transplants were favored in a statistically significant way. No statistically significant differences were observed in regards to patient survival for gender comparisons in all follow-up periods evaluated.CONCLUSIONS The quantitative analysis of the studies suggests that donor or recipient genders, when evaluated isolatedly, do not influence patient or graft survival rates. However, the combination between donor-recipient genders may be a determining factor for graft survival.

No MeSH data available.


Flowchart of study selection for systematic review.
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f01: Flowchart of study selection for systematic review.

Mentions: A total of 5,993 publications were initially identified in the electronic databases, and seven through manual searches, all adding up to 6,000 publications. Of these, 500 publications were excluded because of the participant type, 5,251 due to study type and 177 due to the intervention. The main causes for excluded studies were: studies that did not analyze the outcome of interest (patient and graft survival rates), ones that did not include kidney transplants, review, pharmacokinetic, pharmacoeconomic studies, among others. After duplicate publications were eliminated and the reviewers conducted their analyses, 29 cohort studies were included, which involved 765.753 patients. Among those, six studies compared the measurements from results involving donor genders (MD and FD); eight studies, involving recipient genders (MR and FR), and for 20 others, results involving donor-recipient genders (MD-MR, MD-FR, FD-FR, FD-MR) (Figure). One study was included in donor, recipient, and donor-recipient gender comparisons;5 another one14 was included in the comparison between recipient and donor-recipient genders; and two studies, in the comparison between donor and donor-recipient genders.3,25


Gender in the allocation of organs in kidney transplants: meta-analysis.

Santiago EV, Silveira MR, Araújo VE, Farah Kde P, Acurcio Fde A, Ceccato Md - Rev Saude Publica (2015)

Flowchart of study selection for systematic review.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4587823&req=5

f01: Flowchart of study selection for systematic review.
Mentions: A total of 5,993 publications were initially identified in the electronic databases, and seven through manual searches, all adding up to 6,000 publications. Of these, 500 publications were excluded because of the participant type, 5,251 due to study type and 177 due to the intervention. The main causes for excluded studies were: studies that did not analyze the outcome of interest (patient and graft survival rates), ones that did not include kidney transplants, review, pharmacokinetic, pharmacoeconomic studies, among others. After duplicate publications were eliminated and the reviewers conducted their analyses, 29 cohort studies were included, which involved 765.753 patients. Among those, six studies compared the measurements from results involving donor genders (MD and FD); eight studies, involving recipient genders (MR and FR), and for 20 others, results involving donor-recipient genders (MD-MR, MD-FR, FD-FR, FD-MR) (Figure). One study was included in donor, recipient, and donor-recipient gender comparisons;5 another one14 was included in the comparison between recipient and donor-recipient genders; and two studies, in the comparison between donor and donor-recipient genders.3,25

Bottom Line: Meta-analysis was conducted with the Review Manager® 5.2 software, through the application of a random effects model.Comparison between recipient genders was not found to have significant differences on any evaluated follow-up periods.In the evaluation between donor-recipient genders, male donor-male recipient transplants were favored in a statistically significant way.

View Article: PubMed Central - PubMed

Affiliation: Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, BR.

ABSTRACT

Unlabelled: OBJECTIVE To analyze whether gender influence survival results of kidney transplant grafts and patients.METHODS Systematic review with meta-analysis of cohort studies available on Medline (PubMed), LILACS, CENTRAL, and Embase databases, including manual searching and in the grey literature. The selection of studies and the collection of data were conducted twice by independent reviewers, and disagreements were settled by a third reviewer. Graft and patient survival rates were evaluated as effectiveness measurements. Meta-analysis was conducted with the Review Manager® 5.2 software, through the application of a random effects model. Recipient, donor, and donor-recipient gender comparisons were evaluated.

Results: Twenty-nine studies involving 765,753 patients were included. Regarding graft survival, those from male donors were observed to have longer survival rates as compared to the ones from female donors, only regarding a 10-year follow-up period. Comparison between recipient genders was not found to have significant differences on any evaluated follow-up periods. In the evaluation between donor-recipient genders, male donor-male recipient transplants were favored in a statistically significant way. No statistically significant differences were observed in regards to patient survival for gender comparisons in all follow-up periods evaluated.CONCLUSIONS The quantitative analysis of the studies suggests that donor or recipient genders, when evaluated isolatedly, do not influence patient or graft survival rates. However, the combination between donor-recipient genders may be a determining factor for graft survival.

No MeSH data available.