Impact of Donor–Recipient Sex Mismatch on Graft Function Recovery and Kidney Allograft Survival after Transplantation : Experience from the University Hospital of Guadeloupe

 

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https://storage.unitedwebnetwork.com/files/1288/b1076ac8c3e697e9731632c0205bf5d5.pdf
Impact of Donor–Recipient Sex Mismatch on Graft Function Recovery and Kidney Allograft Survival after Transplantation : Experience from the University Hospital of Guadeloupe

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Arriel
BUNKETE MAKEMBI
Arriel BUNKETE MAKEMBI docteur.makarriel2017@gmail.com University of Kinshasa Nephrology-dialysis Kinshasa Democratic Republic of Congo *
Jonathan MUTOMBO MUAMBA jonathanmuamba43@gmail.com University of Kinhsasa Nephrology-dialysis Kinshasa Democratic Republic of Congo -
Joelle CLAUDEON joelle.claudeon@chu-guadeloupe.fr University Hospital Center of Guadeloupe Nephrology-dialysis-Kidney transplantation Pointe-à-Pitre France -
Cedrick AGLAE cedric.aglae@chu-martinique.fr University Hospital Center of Martinique Nephrology-dialysis Fort de France France -
Tanguy-Fortuné GBAGUIDI tanguy.gbaguidi@ch-cayenne.fr University Hospital Center of Guyane, Cayenne Site Nephrology-dialysis Cayenne France -
Mathilde NOUVIER mathilde.nouvier@choisy-cliniques.com Chosy Clinics Nephrology-dialysis Le Gosier France -
Jimy BATCHO jimy.batcho@chu-guadeloupe.fr University Hospital Center of Guadeloupe Nephrology-dialysis-Kidney transplantation Pointe-à-Pitre France -
Gerard DALVIUS garard.dalvius@chu-guaeloupe.fr University Hospital Center of Guadeloupe Nephrology-dialysis-Kidney transplantation Pointe-à-Pitre France -
Lucile BLAONDEAU lucile.blondeau@chu-guadeloupe.fr University Hospital Center of Guadeloupe Nephrology-dialysis-Kidney transplantation Pointe-à-Pitre France -
Sidibe MOHAMED sidibemohamed15@gmail.com University Hospital Center of Guyane, Cayenne Site Nephrology-dialysis Cayenne France -
Irénée DJICONKPODE i.djiconkpode@ch-ouestguyane.fr University Hospital Center of Guyane, Saint-Laurent-du-Maroni Site Nephrology-dialysis Saint-Laurent-du-Maroni France -
Jean-Robert MAKULO jrmakulo2016@gmail.com University of Kinshasa Nephrology-dialysis Kinshasa Democratic Republic of Congo -
Malika BELGRINE malika.belgrine@ch-cayenne.fr University Hospital Center of Guyane, Cayenne Site Nephrology-dialysis Cayenne France -
Timoté DAVODOUN timote.davodoun@ch-cayenne.fr University Hospital Center of Guyane, Cayenne Site Nephrology-dialysis Cayenne France -
Befa NOTO KADOUKAZA bfanotokadoukaza@yahoo.fr University Hospital Center of Guadeloupe Nephrology-dialysis-Kidney transplantation Pointe-à-Pitre France -

Donor–recipient sex mismatch in kidney transplantation may influence graft function recovery (GFR) and survival, particularly through sex-specific immune mechanisms. This issue is especially crucial in insular territories where access to transplantation is limited.

We conducted a single-center retrospective study at the University Hospital of Guadeloupe (2014–2024), including 335 kidney transplant recipients. Patients were stratified according to donor–recipient sex pairing: MM (male → male), FF (female → female), MF(male → female), and FM (female → male). The primary endpoint was graft function recovery (GFR), while the secondary endpoint was functional graft survival. Statistical analyses included mixed-effects models, Kaplan–Meier estimates, and Cox regression.

The FF group (female → female) achieved the most favorable outcomes: rapid recovery, no return to dialysis, and 100% three-year survival. Conversely, the MF group (male→ female) exhibited the least favorable outcomes, with 11% returning to dialysis and a reduced survival rate (69%). Donor age remained the strongest predictor of impaired recovery, whereas sex mismatch was not an independent factor in multivariate analysis.

Male-to-female mismatch was associated with delayed recovery and reduced graft survival, although not independently after adjustment. Integrating sex matching into allocation strategies could improve transplantation outcomes in resource-limited regions such as the French overseas departments and territories.

Kewords