Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.
Human Sciences, New Public Health, University Osnabrück, Osnabrück, Germany.
Transplantation. 2019 Jun;103(6):1094-1110. doi: 10.1097/TP.0000000000002655.
Organ transplantation as an option to overcome end-stage diseases is common in countries with advanced healthcare systems and is increasingly provided in emerging and developing countries. A review of the literature points to sex- and gender-based inequity in the field with differences reported at each step of the transplant process, including access to a transplantation waiting list, access to transplantation once waitlisted, as well as outcome after transplantation. In this review, we summarize the data regarding sex- and gender-based disparity in adult and pediatric kidney, liver, lung, heart, and hematopoietic stem cell transplantation and argue that there are not only biological but also psychological and socioeconomic issues that contribute to disparity in the outcome, as well as an inequitable access to transplantation for women and girls. Because the demand for organs has always exceeded the supply, the transplant community has long recognized the need to ensure equity and efficiency of the organ allocation system. In the spirit of equity and equality, the authors call for recognition of these inequities and the development of policies that have the potential to ensure that girls and women have equitable access to transplantation.
器官移植作为治疗终末期疾病的一种手段，在医疗体系先进的国家较为常见，在新兴和发展中国家也越来越普及。对文献的回顾表明，该领域存在基于性别的不平等，在移植过程的每一步都有差异报告，包括进入移植等待名单、一旦进入等待名单后的移植机会，以及移植后的结果。在这篇综述中，我们总结了成人和儿科肾脏、肝脏、肺、心脏和造血干细胞移植中基于性别的差异数据，并认为导致结果差异以及女性和女孩获得移植机会不平等的不仅有生物学因素，还有心理和社会经济因素。由于器官需求一直超过供应，移植界早就认识到需要确保器官分配系统的公平和效率。本着公平和平等的精神，作者呼吁认识到这些不平等，并制定有可能确保女孩和妇女平等获得移植机会的政策。
