NEW YORK (Reuters Health) - Younger women have equal access to kidney transplants compared with their male counterparts, but older women receive kidney transplants much less frequently than older men, new research shows.

However, the research team at Johns Hopkins University in Baltimore "found no difference in survival benefit from transplantation between men and women, suggesting that a substantial number of older women who stand to benefit from transplantation lack access to it," they report in their study posted online January 7th by the Journal of the American Society of Nephrology.

The findings are based on a look at more than 560,000 adults with advanced kidney disease reported to the United States Renal Data System and the United Network for Organ Sharing between 2000 and 2005.

The analysis showed that for women ages 18 to 45 years, access to kidney transplantation was equivalent to that of men.

However, gender disparity increased with increasing age, such that women ages 56 to 65 had 15 percent less access than men of the same age. Women between 66 to 75 years old had 29 percent less access, while those older than 75 years had 59 percent less access. The patterns were seen on both the deceased-donor waiting list and live donation.

Women of all ages who had other illnesses, such as diabetes, heart disease or blood vessel disease, also had decreased access compared to men with similar "comorbid" illnesses, Dr. Dorry L. Segev and associates found. Comorbid illness further increased the gender disparity among older women.

Once women were wait-listed, their time to transplantation did not differ from that of men, indicating that "they are equally likely to receive an organ once 'in the system,'" the investigators observed.

The research team speculates that patients and doctors may perceive older and sicker women to be too frail to withstand a major surgical procedure. They recommend further research to design interventions to increase access to renal transplantation for women who are likely to benefit.

SOURCE: Journal of the American Society of Nephrology, online January 7, 2009.

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