The effect of donor-recipient gender mismatch on short- and long-term graft survival in kidney transplantation: a systematic review and meta-analysis

Background There is no limitation of gender matching in renal transplantation. This study was intended to evaluate its effect on short‐ and long‐term graft survival. Methods PubMed, the Web of Knowledge, Medline, the Cochrane Library, and two additional Chinese databases were searched. The data were then ed and meta‐analyzed. Results 14 studies involving 445 279 patients were included. Each study reported data on the four gender matches (male donor‐male recipient, MDMR; male donor‐female recipient, MDFR; female donor‐male recipient, FDMR; female donor‐female recipient, FDFR). The pooled risk ratios (RRs) for 0.5‐, 1‐, 2‐, 3‐, 5‐, and 10‐yr graft survival rates showed that the FDMR group had the worst outcomes, and when recipients were female, short‐term graft survival was worse, but long‐term graft survival was better. The differences between groups changed with time. Conclusions FDMR patients showed poor graft survival. The female recipients had worse short‐term graft survival but the best long‐term graft survival. This study introduces an important consideration into donor‐recipient matching in renal transplantation.