Sex Disparities in Transplantation Access and Outcomes: An Overview

Area of Science:

• Transplantation research
• Organ transplantation disparities
• Sex differences in medicine

Background:

• Sex disparities exist across the entire organ transplant pathway, from evaluation to post-transplant survival.
• Potential contributing factors include healthcare provider bias, biological differences, and gendered behaviors.
• These disparities impact kidney, heart, liver, and lung transplant recipients.

Purpose of the Study:

• To review the current understanding of sex differences in organ transplantation.
• To explore potential mechanisms driving these disparities.
• To examine the combined impact of various factors on transplant access and outcomes.

Main Methods:

• Literature review of existing evidence on sex differences in transplantation.
• Analysis of data across different stages of the transplant trajectory (evaluation, waitlist, post-transplant).
• Consideration of biological and behavioral factors, as well as selection bias.

Main Results:

• Females generally experience more restricted access to transplantation than males, especially at older ages.
• Sex differences in graft loss and mortality rates are influenced by donor sex and recipient age.
• Evidence suggests a complex interplay of factors contributing to observed disparities.

Conclusions:

• A comprehensive understanding of sex differences is the first step toward addressing transplant disparities.
• Further research is essential to elucidate the underlying mechanisms.
• A commitment to equitable access and outcomes by transplant professionals is required.