Equally Interchangeable? How Sex and Gender Affect Transplantation

Area of Science:

• Transplantation Medicine
• Health Equity
• Organ Allocation Systems

Background:

• Organ transplantation is a vital treatment for end-stage diseases, increasingly available globally.
• Existing literature indicates significant sex- and gender-based disparities throughout the transplantation process.
• These inequities affect access to waiting lists, transplant eligibility, and post-transplant outcomes.

Purpose of the Study:

• To review and summarize data on sex- and gender-based disparities in adult and pediatric transplantation.
• To identify contributing factors to inequitable access and outcomes for women and girls.
• To advocate for policies ensuring equitable access to organ transplantation.

Main Methods:

• Comprehensive literature review of sex- and gender-based inequities in kidney, liver, lung, heart, and hematopoietic stem cell transplantation.
• Analysis of data across various stages of the transplant process.
• Synthesis of biological, psychological, and socioeconomic factors influencing disparities.

Main Results:

• Documented differences in access to transplant waiting lists and transplantation.
• Variations in outcomes post-transplantation based on sex and gender.
• Identification of multifaceted contributors including biological, psychological, and socioeconomic elements.

Conclusions:

• Sex- and gender-based inequities persist in organ transplantation, affecting women and girls disproportionately.
• Multifactorial issues contribute to disparities in access and outcomes.
• Urgent recognition of these inequities and policy development are needed to ensure equitable transplantation access for all individuals.