Introduction: Gender equality is a important indicator of the development of countries. Despite the economy growth, gender disparity were still noted for kidney donation and transplantation. In previous studies from the data of Asian Organ Transplantation Registry-WIT-KT, more than 50% of the kidney donors in Australia, India, Japan, the Philippines, South Korea, and Taiwan were females based on the online registry. However, no detailed analysis were conducted afterwards. In the study, we conducted a questionnaire to determine the socioeconomic factors behind the gender imbalance. 
Method:  Patient’s data were retrospectively collected from a single medical center in Taiwan, Chang Gung Memorial Hospital Linkou branch from 1984-2024. A total of 326 groups of living-donor kidney transplantation were analyzed. Questionnaire were given at our outpatient department during follow up. The patients, including the donor and recipients income and other socioeconomic factors were analyzed in our study. This study was approved by the Institutional Review Board of Chang Gung Medical Foundation.
Results: Of the 326 groups of kidney transplantations, 186 of which had female donors. Gender imbalance were still noted in the groups of living-donor kidney transplantations. The data collected from our questionnaire showed a that the between the groups of living-donor kidney transplantations, the recipient had a higher income. 
Conclusion: Gender imbalance were still noted in the groups of living-donor kidney transplantations. Socioeconomic factors, including income may be one the of cause of the gender disparity. However, further studies and other approaches may be needed for better understanding of the gender equality issues behind the phenomenon.