Ten-Year Trends in Kidney Transplantation by Donor Type,Age,Dialysis,and Sex/Gender Inequality in Türkiye

Abstract

Introduction

Gender disparity remains a global issue in access to renal replacement therapy and kidney transplantation among patients with end-stage kidney disease.

Aim

This study examined trends in donor type, recipient age, and dialysis modality in kidney transplantation in Türkiye from 2013 to 2022. A secondary aim was to explore gender disparities in kidney transplantation and treatment modalities for end-stage kidney disease using registry data.

Methods

This descriptive and cross-sectional study analyzed the distribution and trends of kidney transplants in Türkiye between 2013 and 2022. The data were obtained from the publicly accessible Registry of Nephrology, Dialysis, and Transplantation reports in Türkiye. Per million population increase/decrease rate, χ² linear trend, and χ² R by C were used.

Results

Over time, transplants from living donors increased, while deceased donor transplants decreased. The highest rates of living donor transplants were in 2022, 2021, and 2019. Transplants in high-risk age groups increased significantly. There were differences in donor type among patients receiving hemodialysis, peritoneal dialysis, or preemptive transplantation (p < .001). Preemptive transplants showed the most significant increase, especially from living donors in 2022. Between 2013 and 2022, kidney transplantation increased by 24.67% in men and 19.94% in women. Female transplant rates were lowest in 2016, 2020, and 2021, indicating a persistent gender gap. There was no significant gender difference in the incidence of hemodialysis or peritoneal dialysis.

Conclusion

Living donor transplants, especially preemptive ones, increased markedly over the past decade. Gender disparities persist, and efforts should focus on improving access for women and promoting deceased donor programs to ensure equity.