Gender disparity in living donor kidney transplantation in Bangladesh: a multicenter retrospective cohort study

Background and aims

Gender disparity is reported in both organ donation and transplantation worldwide. However, this matter has not been studied to date in Bangladesh. We evaluated the extent of gender disparity in kidney transplantation (KT) in Bangladesh over the past 8 years.

Methods

We conducted a multicenter retrospective cohort study including kidney transplant donors and recipients from Bangladesh spanning the years 2015–22. Data were collected from hospital transplant records of four major kidney transplant centers in Bangladesh. We assessed differences in organ donation and transplantation by donors’ and recipients’ gender and described gender disparities related to living-related donor–recipient pairs, using descriptive statistics.

Results

From 2015 to 2022, 1314 living-related KT took place in Bangladesh. Among them, the majority (80%) of recipients were male, while only 20% were female. In the case of donors, females constituted the main bulk (78%) of living kidney donors, whereas males represented the minority of donors (22%). Similarly, in ABO incompatible KT, the maximum (87.5%) recipients were men, while most donors (87.5%) were women. Mothers were the most frequent female donors (41.9%), followed by wives (15.6%) and sisters (15.1%). Gender disparity in donation was most prominent in spousal donation, where 95.3% of donors were wives and only 4.7% were husbands.

Conclusion

Our study demonstrated that there is a significant gender gap in kidney donation and transplantation in Bangladesh. The observed disparities appear greater than those reported in many published studies from Asia-Pacific and Western countries.

Learning points