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Kidney transplantation and donation in the transgender population: A single‐institution case series
Author(s) -
Ramadan Omar I.,
Naji Ali,
Levine Matthew H.,
Porrett Paige M.,
Dunn Ty B.,
Nazarian Susanna M.,
Weinrieb Robert M.,
Kaminski Mary,
Johnson David,
TrofeClark Jennifer,
Lorincz Ilona S.,
Blumberg Emily A.,
Weikert Blair C.,
Bleicher Melissa,
Abt Peter L.
Publication year - 2020
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.15963
Subject(s) - medicine , transgender , psychosocial , population , transplantation , kidney transplantation , donation , surgery , psychiatry , psychology , environmental health , psychoanalysis , economics , economic growth
The medical needs of the transgender population are increasingly recognized within the US health care system. Hormone therapy and gender‐affirming surgery present distinct anatomic, hormonal, infectious, and psychosocial issues among transgender kidney transplant donors and recipients. We present the first reported experience with kidney transplantation and donation in transgender patients. A single‐center case series (January 2014‐December 2018) comprising 4 transgender kidney transplant recipients and 2 transgender living donors was constructed and analyzed. Experts in transplant surgery, transplant psychiatry, transplant infectious disease, pharmacy, and endocrinology were consulted to discuss aspects of care for these patients. Four transgender patients identified as male‐to‐female and 2 as female‐to‐male. Three of 6 had gender‐affirming surgeries prior to transplant surgery, 1 of whom had further procedures posttransplant. Additionally, 4 patients were on hormone therapy. All 6 had psychiatric comorbidities. The 4 grafts have done well, with an average serum creatinine of 1.45 mg/dL at 2 years (range 1.01‐1.85 mg/dL). However, patients encountered various postoperative complications, 1 of which was attributable to modified anatomy. Thus, transgender kidney transplant patients can present novel challenges in regard to surgical considerations as well as pre‐ and posttransplant care. Dedicated expertise is needed to optimize outcomes for this population.