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Thursday, April 18, 2024

Girls less likely to be placed on transplant waitlist

A recent study of children waiting for kidney transplants has found that girls are less likely than boys to be placed on the waiting list to receive a kidney.

The study was conducted by researchers at the UC Davis School of Medicine (UCDSM) and found that girls under the age of 21 are 22 percent less likely than boys of the same age to be placed on the waitlist, even after controlling for factors like medical diagnosis or family preference.

According to Stephanie Nguyen, a pediatric nephrologist at UCDSM, researchers who have previously studied this gender disparity initially speculated that perhaps girls developed renal failure faster than boys, which could prevent health care providers from preparing them for transplant.

“However, our research does not suggest this as we tried to adjust for the underlying diagnosis as a potential confounding factor,” Nguyen said.

The researchers say that their findings are crucial because if girls aren’t placed on the waiting list as often as boys, then they must spend more time on dialysis than boys. Dialysis, a procedure that replaces lost kidney function by filtering wastes from the blood, is not a good long-term substitute for healthy kidneys.

A prior study by a different group of UC Davis researchers, conducted in December 2010, found that the longer a child is on dialysis while awaiting a kidney transplant, the greater likelihood that the child’s transplantation will be unsuccessful.

“Children who face kidney transplant fare best when they receive the organ without undergoing dialysis,” said Lavjay Butani, chief of pediatric nephrology at the UCDSM and the lead author of the study, in a UCDSM press release. “The longer the dialysis prior to the operation, the worse is the survival of the kidneys.”

Researchers are unsure exactly why girls are not being placed on the kidney transplantation waitlist as often as boys. The researchers looked at all the children on dialysis at different points in their treatments. Regardless of when the researchers checked back on the list of children awaiting placement on the transplant list, whether at the beginning of dialysis or 12 months later, there were always more girls awaiting placement.

“The study by Dr. Nguyen and her group poses important questions that need to be addressed, to better explore and understand the reasons behind this gender difference in access to organ transplants and to determine if there are biological factors that may lead to a more time-consuming work-up to prepare girls for a transplant,” Butani said in the UCDSM press release. “In the absence of such considerations, it is the responsibility of all health-care providers treating this population to facilitate rapid transition of all children who are dialysis-dependent toward successful transplantation.”

Establishing priority for organ recipients is a difficult issue given the large number of people awaiting transplant. In 1984, the United States Congress passed the National Organ Transplant Act, which called for a unified transplant network by a private non-profit organization operating under federal contract. This act established the Organ Procurement and Transplantation Network and awarded its contract to the United Network for Organ Sharing (UNOS) in September 1986.

In order to match donors to potential recipients on the waitlist, UNOS records donor and recipient medical records as well as screenings for blood type and HIV status. Doctors must then maintain required care such as antibiotics and monitoring blood pressure for deceased donors and obtain consent from all parties.

AMY STEWART can be reached at science@theaggie.org.

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