Received October 24, 2008
Accepted on April 15, 2009

CLINICAL EPIDEMIOLOGY

H-Y Incompatibility Predicts Short-Term Outcomes for Kidney Transplant Recipients

S. Joseph Kim ^*1 and John S. Gill

*Division of Nephrology, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, and Division of Nephrology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada

¹ To whom correspondence should be addressed. E-mail: joseph.kim{at}uhn.on.ca.

	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.