Impact of sex on clinical outcomes according to immunologic risk in spouse donor kidney transplantation

Abstract The aim of this study is to investigate the impact of sex on the clinical outcomes of spouse donor kidney transplantation (SDKT). We analyzed 456 SDKT recipients, and categorized them into standard or high immunological risk groups according to Panel reactive antibody ≥ 50 % or less. There were 366 recipients in the standard risk group, and 89 recipients in the high-risk group. When comparing biopsy-proven allograft rejection (BPAR) within one year from KT, H2W recipients showed significantly higher incidence than W2H recipients in the high-risk group. By contrast, there was no significant difference between W2H and H2W recipients in the standard risk group. Allograft function recovery was better in H2W recipients than in W2H recipients in each group, while H2W recipients in the high-risk group showed a more rapid decline than other recipients. The long-term patient and allograft survival rates showed no difference between H2W recipients and W2H recipients within the same groups. The H2W recipients with high immunological risk showed higher risk of BPAR compared to W2H recipients, so careful monitoring and management may be required.