Gender disparities in liver transplantation

Area of Science:

• Hepatology and Transplant Surgery
• Medical Ethics and Health Policy

Background:

• Gender disparities significantly impact liver disease prevalence, progression, and outcomes.
• Women face unique challenges in liver disease, including metabolic and autoimmune conditions.
• Existing liver transplantation (LT) systems exhibit gender-based inequities.

Purpose of the Study:

• To review and synthesize current knowledge on gender disparities in liver transplantation.
• To identify biological, physiological, psychosocial, and systemic factors contributing to these disparities.
• To advocate for policy reforms and interventions to promote equitable LT access and outcomes.

Main Methods:

• Systematic review of epidemiological studies and existing literature on gender in liver transplantation.
• Analysis of factors influencing liver disease etiology, progression, and LT access.
• Examination of biases within current LT allocation systems, including MELD scoring and size matching.

Main Results:

• Consistent gender-based differences observed in liver disease patterns and progression.
• Women encounter significant barriers to LT access despite higher disease severity.
• Allocation systems (e.g., MELD score) and psychosocial factors perpetuate inequities.

Conclusions:

• Evidence-based policy reforms, including revised MELD scoring and standardized evaluations, are essential.
• Multidisciplinary research, targeted interventions, and community engagement are critical.
• Achieving equitable liver transplantation outcomes requires addressing gender disparities proactively.