Gender disparity in Indian renal transplantation

Gender disparities are a major ethical concern in renal donation and transplantation. Relatively few Indian studies, each limited by small sample sizes, have investigated the problem of gender disparities in renal transplantation. Methods: A retrospective, cross-sectional study was conducted using data collected from kidney transplantation centers in Kerala, a southern state of India, to analyze the gender disparity in kidney donation and transplantation. Data were collected on gender, age, and relationship of the donor to the recipient. Results: Among 592 related cases, 74.2% of donors were female and 25.8% male (p <.0001). In the case of recipients, 76.2% were male and 23.8% female (p <.0001). Among 110 unrelated donors, 30.9% were female and 69.1% male (p <.0001), while the recipients were 78.2% male and 21.8% female (p <.0001). The number of cadaver kidney transplantations (six) was too small for analysis. Conclusion: The study found that the majority of living-related donors are family members (first-degree relatives) of the affected patients, with a definite female gender disparity among donors and recipients, more pronounced than reported in other studies. This disparity was absent in the case of living-unrelated donors, however. Existing practices in the organ transplantation process should be reviewed in order to eliminate the donor gender disparity in India. Kidney transplantation registries and organ matching systems at the national, state, and district levels are necessary for accountability and regulation of the transplantation process in India.