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Meta-Analysis
. 2015:49:68.
doi: 10.1590/S0034-8910.2015049005822. Epub 2015 Oct 9.

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

[Article in English, Portuguese]
Erika Vieira Almeida e Santiago  1 , Micheline Rosa Silveira  1 , Vânia Eloisa de Araújo  2 , Katia de Paula Farah  3 , Francisco de Assis Acurcio  1 , Maria das Graças Braga Ceccato  1
Affiliations
Meta-Analysis

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

[Article in English, Portuguese]
Erika Vieira Almeida e Santiago et al. Rev Saude Publica. 2015.

Abstract
in English, Portuguese

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.

OBJETIVO: Analisar se o gênero influencia os resultados da sobrevida do enxerto e do paciente no transplante renal.

MÉTODOS: Revisão sistemática com metanálise de estudos de coorte disponíveis nas bases de dados Medline (PubMed), Lilacs, Central e Embase, incluindo busca manual e na literatura cinzenta. A seleção dos estudos e a coleta dos dados foram realizadas em duplicata por revisores independentes e as discordâncias foram resolvidas por um terceiro revisor. A sobrevida do enxerto e do paciente foram avaliadas como medidas de efetividade. A metanálise foi conduzida no softwareReview Manager ® 5.2, aplicando o modelo de efeitos aleatórios. Foram avaliadas as comparações entre gênero de receptor, doador e doador-receptor.

RESULTADOS: Foram incluídos 29 estudos envolvendo 765.753 pacientes. Em relação à sobrevida do enxerto, aqueles provenientes de doadores masculinos apresentaram maior sobrevida quando comparado com aqueles de doadores femininos, somente no tempo de acompanhamento de 10 anos. A comparação entre gênero de receptor não apresentou diferença significativa em nenhum tempo de acompanhamento avaliado. Na avaliação entre gênero de doador-receptor houve favorecimento estatisticamente significante para doador masculino-receptor masculino. Não houve diferença, estatisticamente significante, na sobrevida do paciente para as comparações entre gênero em todos os períodos de acompanhamento avaliados.

CONCLUSÕES: A análise quantitativa dos estudos sugere que o gênero do doador ou do receptor, avaliado isoladamente, não influencia na sobrevida do enxerto e paciente. Contudo, a combinação entre gênero de doador-receptor pode ser fator determinante para a sobrevida do enxerto.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure
Figure. Flowchart of study selection for systematic review.
Figura
Figura. Fluxograma da seleção de estudos para a revisão sistemática.
See this image and copyright information in PMC

References

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