Gender disparities in the live kidney donor evaluation process.
BACKGROUND: Females are live kidney donors more often than males. We examined the pool of potential donors to determine at what point in the donor evaluation process this gender disparity develops. METHODS: We selected patients who underwent blood typing as potential live kidney donors for recipients being evaluated for transplantation at our center between January 2000 and January 2004. We reviewed patient records to determine when in the evaluation process elimination occurred: ABO incompatible, positive cross-match, no medical workup, medical workup incomplete, medical contraindication, social contraindication, recipient too sick or dead, approved but did not donate, or donated. RESULTS: A total of 506 potential donors (55% female, 45% male) were evaluated. Males and females were equally likely to get through each step of the evaluation and be approved for donation. Overall, females were significantly more likely to donate than males. However, when approved donors are divided into those who were evaluated during the open nephrectomy (ON) era versus the laparoscopic nephrectomy (LN) era, the gender disparity among donors was present only in the ON era. In the ON era, there were 54 donors, 37 females and 17 males (P=0.004), whereas in the LN era, there were 61 donors, 32 females and 29 males (P=NS). CONCLUSION: Among potential donors approved for donation, females have been significantly more likely to donate than males. The introduction of LN at our center was associated with a decrease in the gender difference in kidney donation.